Association between Sleep Duration and Presbycusis in Korean Adults: Korea National Health and Nutrition Examination Survey / 가정의학회지

Background@#Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years. @*Methods@#We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010–2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and 40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates. @*Results@#The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration. @*Conclusion@#Our findings suggest that sleep duration is associated with the prevalence of presbycusis.

Association of Hand Grip Strength and Cardiometabolic Markers in Korean Adult Population: The Korea National Health and Nutrition Examination Survey 2015-2016 / 가정의학회지

Background@#Muscle strength has been suggested as a cardiovascular marker. The aim of this study was to examine the associations between hand grip strength and biomarkers of cardiovascular disease in the Korean population. @*Methods@#A total of 9,083 participants aged 20–80 years from Korea National Health and Nutrition Examination Survey 2015–2016 were investigated. @*Results@#Among men, both relative and dominant hand grip strength showed a positive association with diastolic blood pressure in those aged 65–80 years (95% confidence interval, P-value of dominant and relative hand grip strength: β=0.06, 0.01; P<0.05). Among women, relative and dominant hand grip strength showed a positive relationship to diastolic blood pressure in those aged 20–64 years (β=0.06, 0.01; P<0.001). Body mass index was positively associated with dominant hand grip strength in younger women (β=0.18, P<0.05), whereas it was positively associated with relative hand grip strength in all sex and age groups. High-sensitivity C-reactive protein showed a negative association with relative and dominant hand grip strength in all women, although the same association was observed only in younger men. Diabetes was inversely related to hand grip strength in younger women and men. @*Conclusion@#Increased hand grip strength may be associated with lower C-reactive protein in women and with less risk of diabetes in the Korean adult population. Further prospective studies are needed for the determination of causality between cardiometabolic markers and hand grip strength.

The Association between Vitamin D and Health-Related Quality of Life in Korean Adults / 가정의학회지

BACKGROUND: We examined the relationship between vitamin D status and health-related quality of life, and explored other related factors in the general Korean population. METHODS: We used data from the 2007-2012 Korea National Health and Nutrition Examination Survey on 14,104 adults, aged 20-49 years, who had consented to serum vitamin D measurement and answered health-related quality of life questions. EuroQol-5 was used for measurement. Serum vitamin D levels were measured at intervals of 0-9.99, 10-19.99, 20-29.99, and ≥30 ng/mL. RESULTS: Participants with higher serum vitamin D (serum 25-hydroxyvitamin D) levels were significantly less likely to report problems with depression and anxiety. After adjustment for age, gender, income level, education level, marital status, alcohol consumption, smoking status, and the existence of depressive disorders, the odds ratio for reporting a problem with depression and anxiety was 0.60 (95% confidence interval [CI], 0.39-0.91). The odds ratio for the prevalence of any problem was 0.69 (95% CI, 0.53-0.89) before adjustment, but was not statistically significant after adjustment. No significant associations were observed for problems with mobility, self-care, usual activity, or pain and discomfort. CONCLUSION: This is the first study to examine the associations between vitamin D and health-related quality of life for the general Korean population. Vitamin D status was not significantly associated with the dimensions of EuroQol-5 except for depression and anxiety problems.

Proangiogenic cells enhanced persistent and physiologic neovascularization compared with macrophages

Proangiogenic cells (PACs) display surface markers and secrete angiogenic factors similar to those used by myelomonocytic cells, but, unlike myelomonocytic cells, PACs enhance neovascularization activity in experimental ischemic diseases. This study was performed to reveal the differential neovascularization activities of PACs compared with those of myelomonocytic cells. We cultured PACs and CD14+-derived macrophages (Macs) for 7 days. Most of the surface markers and cytokines in the two cell types were alike; the exceptions were KDR, beta8 integrin, interleukin-8 and monocyte chemotactic protein-1. Unlike Macs, PACs significantly enhanced mesenchymal stem cell (MSC) transmigration. PACs and Macs increased neovascularization activity in an in vitro co-culture of human umbilical vein endothelial cells and MSCs and in an in vivo cotransplantation in Matrigel. However, the use of Macs resulted in inappropriately dilated and leaky vessels, whereas the use of PACs did not. We induced critical hindlimb ischemia in nude mice, and then transplanted PACs, Macs or vehicle into the mice. We obtained laser Doppler perfusion images weekly. At 2 weeks, mice treated with PACs showed significantly enhanced perfusion recovery in contrast to those treated with Macs. After day 7, when cells were depleted using a suicidal gene, viral thymidine kinase, to induce apoptosis of the cells in vivo by ganciclovir administration, we found that the improved perfusion was significantly abrogated in the PAC-treated group, whereas perfusion was not changed in the Mac-treated group. PACs caused an increase in healthy new vessels in in vitro and in vivo models of angiogenesis and enhanced long-term functional neovascularization activity in the hindlimb ischemia model, whereas Macs did not. Nevertheless, the angiogenic potential and long-term functional results for a specific cell type should be validated to confirm effectiveness and safety of the cell type for use in therapeutic angiogenesis procedures.

Effect of Video-Education on Pre-Procedure Anxiety / 가정의학회지

BACKGROUND: The value of endoscopy is more increasing as a tool of the cancer screening, and many studies are now progressed for decreasing the inconvenience of patients who undergo the endoscopy. There are some overseas studies that the video-education before procedures like colonoscopy or coronary angiography increases the satisfaction and decreases the anxiety of the patients. But in Korea, there is lack of studies about the methods of decreasing the anxiety of the patients before procedures especially endoscopy. METHODS: We carried out the survey with 95 patients underwent the endoscopy in the medical health checkup center of National Health Insurance Medical Center during 19 July 2008 to 8 September 2008. The patients who had the medical history of gastrectomy, had pains due to another diseases and had a prescription about psychiatric medicine including hypnotics were excluded. RESULTS: Statistically there are no differences between two groups of the video-education and the paper-education according to age, sex, height, weight, body mass index, numbers of former endoscopy, smoking history and educational standard. The video-education is more effective than the paper-education in decreasing the anxiety index between before and after the education. CONCLUSION: The prior video-education for the patients awaiting endoscopy can decrease the anxiety about procedure. Moreover, it can decrease the suffication of the patients and increase the satisfaction of physicians. If the patients feeling the prior anxiety are educated with the video before undergoing endoscopy, the video-education is very effective to decrease the prior anxiety of the patients.

Predictors Related to the Non-alcoholic Fatty Liver Disease / 가정의학회지

BACKGROUND: As the metabolic syndrome is increased, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increased. In recent studies, metabolic syndrome is related to serum uric acid. And some authors reported the association of uric acid and NAFLD. We have studied the association of serum uric acid and NAFLD. METHODS: The authors conducted a cross-sectional survey of 3,430 subjects out of 6,731 individuals who had visited the Health Promotion Center at the National Insurance Corporation Ilsan Hospital for the purpose of a regular check-up from January 2005 to April 2008. We excluded who showed evidence of more than moderate alcohol consumption, hepatitis B or C, or severe hepatic dysfunction. RESULTS: Among 3,430 participants, 1,775 subjects (51.7%) were diagnosed with NAFLD and 1,655 subjects (48.3%) were control. Age, BMI, triglyceride, fasting glucose, uric acid were greater in the patients with NAFLD than in the controls. The severity of NAFLD is related to uric acid. When uric acid is divided in 4 groups, elevation of uric acid is associated with risk for NAFLD. This relationship is showed in similar pattern when adjusting for age, sex, BMI, triglyceride, fasting glucose. The uric acid elevation of 1mg/dL is associated with the increase of 1.11 fold in risk for NAFLD. CONCLUSION: The risk for non-alcoholic fatty liver disease is related to uric acid. And the severity of non-alcoholic fatty liver disease is associated with uric acid.

Criterion-Related Validity of the Critical Patients' Severity Classification System Developed by the Hospital Nurses' Association / 성인간호학회지

PURPOSE: This study was conducted to test criterion-related validity of the Critical Patients' Severity Classification System (CPSCS) developed by the Hospital Nurses' Association by examining relationships with brain injury severity measured by Glasgow Coma Scale (GCS), recovery state measured by Glasgow Outcome Scale (GOS), and days of stay in ICU of brain injury patients. METHODS: Prospective correlational research design was adopted by including 194 brain injury patients admitted to ICU of one university hospital. RESULTS: The score of CPSCS appeared to significantly discriminate the severity of brain injury. Among nursing activities in CPSCS, Respiratory therapy, IV Infusion and Medication, Monitoring, Activities of Daily Living (ADL), Treatment and Procedure were significant to discriminate the severity of brain injury. Respiratory therapy, Vital Signs, and Monitoring appeared to significantly discriminate the recovery states of 1- and 3-months. Nursing activities significantly contributed to predict the days of ICU stay were Respiratory therapy, ADL, and Teaching and Emotional Support. CONCLUSION: CPSCS developed by the Hospital Nurses Association appeared to be valid to discriminate or predict brain injury severity, recovery states, and days of stay in ICU for brain injury patients.

Metabolic Syndrome and Oxidative Stress, Antioxidants

No abstract available.

Effects of rhGH on Body Composition and Subjective Physical Functions in Adults with Functional Growth Hormone Deficiency

BACKGROUND: There is a significant amount of evidence to indicate that some of the changes attributed to aging process can be partially reversed by GH replacement. But the GH replacement for somatopause with functional GH deficiency is still controversial. The aim of this study was to explore whether the short term GH replacement improved physical, emotional and sexual function as well as body composition. METHODS: A total of 31 adults with functional growth hormone deficiency were assigned to receive rhGH with an initial daily dose of 1.05 IU, six times a week. For evaluating physical change a 25-item questionnaire was administered to patients at initial visit and 6 months later. Body composition was determined by bioimpedence analysis at initial visit and 6 months later as well. We compared the changes for each variable using Wilcoxon's rank and Friedman's test. RESULTS: Serum IGF-1 level at 3 and 6 months were increased significantly by 31% and 43%, respectively, compared to baseline (P<0.0001). Lean body mass and percent body fat at 6 months of treatment showed a 2.2% increase and a 7.6% decrease with statistical significance. The score of the questionnaire at 6 months of treatment increased significantly in physical changes (P<0.0005), sexual function (P<0.001), self perception of physical appearances (P<0.02), chronic fatigue & immunity (P<0.03), and vitality (P<0.05). CONCLUSION: Adults with functional growth hormone deficiency showed improvements in not only body composition, but also physical function and appearances and sexual function after 6 months of treatment with rhHGH.

Serum Insulin-Like Growth Factor I and Its Relating Factors in Healthy Korean Adults Aged over 40 Years

BACKGROUND: There is a clinical need for a reference value based on healthy adults in Korea. The aim of this study was to define IGF-1 concentration in healthy Korean adults and to investigate the factors relative to IGF-1 level. METHODS: By reviewing the medical records of a hospital in Korea, healthy 112 men and 109 women aged over 40 years were studied. We determined the serum IGF-1 levels of both groups according to age, sex, health behaviors, lipid profile, bone mineral density, serum albumin, waist circumference, body mass index, total testosterone, and FSH. RESULTS: IGF-1 had no sexual difference in any age group (258.7+/-84.3 ng/mL for men, 263.7+/-86.8 ng/mL for women), but correlated negatively with age (r=-0.43 and -0.35 for men and women, respectively). The mean decline was 49.6 ng/mL and 43.9 ng/mL per 10 years for men and women, respectively. IGF-1 correlated positively with serum albumin, total cholesterol, and bone mineral density of spine and femur neck. The multiple regression analysis showed that the most powerful factors influencing IGF-1 level was serum albumin (R2; 0.13) followed by age, bone mineral density of femur neck, and total cholesterol. CONCLUSION: We present a reference value for IGF-1 in healthy Korean adults aged over 40 years. The most powerful factor influencing IGF-1 level was serum albumin.

The Predictors of Growth Hormone Secretion after L-dopa Stimulation Test in Adults

BACKGROUND: Twenty four-hour GH secretion reaches a peak in puberty and declines by 14% every decade in adult life. By age 60, most adults have a total 24-hour secretion rate indistinguishable from those of hypopituitary patients with organic lesions in pituitary gland. We performed this study to know about the predictors of GH secretion after L-dopa stimulation test in adults. METHODS: One hundred and ninety eight patients over the age of 45, who visited the menopausal clinic from Oct. 2001 to May 2002, were studied. We compared the peak GH value after the administration of L-dopa 500 mg by gender and age groups. Also, we compared the GH deficiency group to normal by anthropometric and measured variables. RESULTS: The mean of the stimulated GH peak value and the prevalence rate of growth hormone deficiency were greater in women than in men. GH-AUC after L-dopa stimulation correlated well with all measurements of adiposity. In GH deficiency group, the mean values of measured variables about adiposity were greater than normal in statistical significance. Logistic regression test revealed sex and abdominal obesity contributed significantly to predict GH deficiency after L-dopa stimulation test. The odds ratio of GH deficiency were 3.0 in women compared to men with 2.9 in abdominal obesity. CONCLUSION: Gender and adiposity were the predictors of GH deficiency in adults after L-dopa stimulation test rather than age and IGF-1 values.

Reasons of delay of hospital presentation in patients with acute stroke

BACKGROUND: Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time dependent. Patients with acute stroke often arrive at the hospital too late to receive the maximum benefit from these new stroke therapies. Efforts to reduce delay time of therapy for acute stroke may be more effective if the factors that delay hospital arrival are identified and targeted for specific intervention. So we studied about reason of delay of hospital presentation in patients with acute stroke. METHODS: The 85 acute stroke patients group who admitted to the Young-dong severance hospital from April to August 1999 were enrolled in this study. We collected clinical data from the medical record, including demographic characteristics, date and time of symptom onset, date and time of presentation to the hospital, medical history, and symptoms at stroke onset. And informants about stroke, method of transportation, the patient's interpretation of the symptoms were interviewed. We defined early arrival as within 3 hours of awareness of symptoms. RESULTS: The 85 patient were interviewed, early arrival were more likely to arrive by ambulance(P<0.001), admit via emergency department(P=0.001), interpret their symptoms as a stroke(P=0.005) and use readings as a informants about stroke(P=0.027) than late arrivals. Also they were younger than late arrivals(P=0.027). Main reason of delay of hospital presentation was because they expect spontaneous improvement(43%), mistake as other disease(23.3%), arrive via other medical institute(20%). CONCLUSION: Late arrivals expected spontaneous improvement, misinterpreted their symptoms as those of other disease and didn't choose proper medical institute for acute management. Considerable education is needed to increase the knowledge about stroke and proper acute management.

Intrafamilial distribution patterns and clinical characteristics of hepatitis C in Anti HCV seropositives using HCV PCR

BACKGROUND: The prevalence of hepatitis C in blood donors have been reported to be 1.5% to 2.0% and 85 90% of post transfusion hepatitis patients show anti HCV positive results. Most agree that hepatitis C is readily spread by way of contact with blood, but a discernible history of parenteral exposure is identified in only 40% to 50% of cases. Thus other possible nonparenteral routes of transmission such as vertical, sexual and intrafamilial contact transmission need to be explored. In this study, we investigated the clinical characteristics of anti HCV seropositives and the infection patterns of hepatitis C in their families not only by anti HCV but also by HCV PCR to explore the possibility of HCV infection through nonparenteral household contact. METHODS: Past history, physical examination, liver function tests, HCV PCR, hepatitis B viral markers, abdominal ultrasonography and liver biopsy were done in 161 anti HCV seropositives from May, 1991 to August, 1996. Of the 161 seropositives, 42 seropositives' family members, 98 subjects, were available for investigation by anti HCV, HCV PCR and liver function tests to document intrafamilial HCV infection;their respective relationships to the index seropositive were noted. RESULTS: The 161 anti HCV seropositives were classified as follows:34 in the carrier group(21.1%), 41 in the acute hepatitis group (25.5%), 32 in the chronic hepatitis group(19.9%), 24 in the liver cirrhosis group(14.9%) and 30 in the hepatoma group(18.6%). The positive rates of HCV PCR were 55.2% in total, 46.1% in the carrier group, 55.0% in the acute hepatitis group, 76.4% in the chronic hepatitis group, 40.0% in the liver cirrhosis group, and 42.8% in the hepatoma group. The 98 family members were all anti HCV seronegative. The positive rates of HCV PCR in these family members were 10.2% in total, 7.1% in spouses, 28.6% in siblings, and 8.3% in children. CONCLUSION: Anti HCV seropositives were in various clinical states of liver disease due to HCV infecton. Although none of the family members showed anti HCV positive results, HCV PCR was positive in 10.2% of the family members indicating the need to perform HCV PCR to detect HCV infection.

Major health related problems among adolescents in Seoul area

BACKGROUND: Adolescence offers unique opportunities for investment in health and well-being. The purpose of this study was to examine the common physical symptoms and diseases and medical utilization rate and the prevalence of health behaviors among school-aged adolescents. METHODS: This study was carried in 1998. Subjects consisted of 3,771 adolescents (ages 10 to 18) who attended an elementary, middle, and high school in Seoul and 3,246 parents. Self-report questionnaire was administered to the students and their parents to measure self-reported physical and psycho\social problems, practice of health behavior, medical care utilization rate, and the most common diagnosis. RESULTS: 1) Academic performance was the most common psycho\social problem for adolescents and their parents. 2) The perceived health status was highest in middle school students, lowest in female high school students. 3) As adolescents went to higher grades, the medical institute and dental clinic utilization rate tended to be decreased, and oriental clinic utilization rate did not change. The most common diagnosis during the past year was dental caries. The next most common diagnosis was respiratory infection. Accidents (males), headache (females) were more common in high school than middle school. 4) The most frequently reported symptom was fatigue in middle and high school students. More than half of female high school students reported fatigue, dizziness, headache, dysmenorrhea, hypersomnia during the last month. 5) The higher their grade was, the less adolescents practiced health behaviors. 21.9% of males and 1.9% of female high school students were smokers. 34.5% of males and 13.3% of female high school students drank alcohol on a regular basis. The prevalence of obesity was 12.0% in males, 10.0% in female high school students. Male adolescents tended to deal with stress with leisure activities, female adolescents did by talking about their problems with related people. CONCLUSION: This overview of health associated issues among adolescents provided a unique view of differences in health care needs between younger and older teens and between male and female teens. These data have meaningful implications for health promotion program for adolescents.

Reliability and validity of Korean templer's death anxiety scale, death depression scale and sense of symbolic immortality scale

BACKGROUND: Means to measure death anxiety, death depression and sense of symbolic immortality with approved validity and reliability does not yet exist in Korea. METHODS: Existing English questionnaires such as Templer Death Anxiety Scale (TDAS), Death Depression Scale (DDS), Sense of Symbolic Immortaligy Scale (SSIS) were translated into Korean by 5 translators, and then reviewed by 3 non-participants of translation for collegial summary and this summary was counter-translated again by another 2 non-participants. Another 3 non-participants of translation and counter-translation were chosen to examine the two sentences of each item. Then reexamination was done by retranslating and counter-translating the parts with errors. Aftr pretest on ordinary people. the completed questionnaires were given to medical students, residents and nurses of a university hospital. Pastors and missionaries were selected as comparison group. RESULTS: Kuder-Richardson or Cronbach-alpha that represent internal consistency of TDAS, DDS and SSIs was 0.69, 0.84 and 0.78. The three sentences that lowered internal consistency of SSIS was deleted. BDI and DDS showed a positive correlation (0.32, P=0.02), suggesting proved construct validity. Correlation coefficient that proves construct validity of TDAS and DDS was 0.54 (P<0.01), of SSIS and TDAS -0.23(P=0.04), of SSIS and DDS -0.29(P=0.01). The TDAS and DDS(P<0.01), DDS and BDI(P=0.02) have shown a positive correlation were shown. There was significant difference in the score of SSIS(P<0.01). The same results in cases where the 3 sentences was deleted. CONCLUSION: Korean versions of TDAS, DDS and SSIS were reliable and valid.