Association between Abdominal Obesity and Oxidative Stress in Korean Adults / 가정의학회지

BACKGROUND: Obesity causes several changes in the body and is associated with both inflammation and oxidative stress. However, the relationship between abdominal obesity, diacron-reactive oxygen metabolites (d-ROMs), and biological antioxidant potential (BAP) levels in Korean adults has not yet been proved. The aim of this study was to evaluate the association between d-ROMs, BAP levels, and abdominal obesity in the Korean adult population using clinical data. METHODS: A total of 2,367 individuals, aged 18–86 years, were identified from health check-up examination records at a university hospital, between January 2015 and August 2016. Clinical and biochemical parameters, including waist circumference, lipid profile, alcohol drinking status, and smoking status, were investigated. Oxidative stress levels, viz., d-ROM concentration and antioxidant capacity, viz., BAP, were measured. RESULTS: Subjects with abdominal obesity presented significantly higher levels of d-ROMs compared to those with a normal waist circumference (P<0.001). After adjusting for age, sex, alcohol drinking status; smoking status; and triglyceride, low-density lipoprotein levels were found to have a significant positive correlation with abdominal obesity (P<0.001). BAP did not significantly correlate with abdominal obesity. CONCLUSION: We observed a positive association between abdominal obesity and d-ROM concentration. This result indicates that abdominal obesity can increase oxidative stress and may affect the pathways involved in obesity, such as the inflammatory pathway. Such correlation analyses were helpful in revealing the causes, as well as methods to reduce, oxidative stress.

Association between Serum Uric Acid and Oxidative Stress in Korean Adults / 가정의학회지

BACKGROUND: Oxidative stress is implicated in the pathogenesis and development of lifestyle-related diseases. In the present study, we evaluated the correlation between the serum uric acid (UA) levels and oxidative status in Korean adults. METHODS: The subjects were 5,093 individuals (2,041 women and 3,052 men) who underwent a health checkup between June 2012 and December 2016. Oxidative stress levels (derivatives of reactive oxygen metabolites [d-ROMs]) and antioxidant potential (biological antioxidant potential [BAP]) were measured. Metabolic markers, including UA, were also examined. RESULTS: Higher serum UA levels were associated with decreased levels of d-ROMs (P < 0.05). The UA levels were positively associated with BAP levels (P < 0.001). CONCLUSION: Serum UA is related to oxidative status, especially antioxidant capacity, in Korean adults; UA may play a role in antioxidant defense systems in humans.

Changes in Body Composition Predict Homocysteine Changes and Hyperhomocysteinemia in Korea

Cardiovascular disease (CVD) is the primary cause of death in Korea. Hyperhomocysteinemia confers an independent risk for CVD comparable to the risk of smoking and hyperlipidemia. The purpose of this study was to assess the effect of cardiovascular risk factors and body composition change on homocysteine (Hcy) levels in Korean men and women. The association between body composition and Hcy levels was investigated in a 2-yr prospective cohort study of 2,590 Koreans (mean age 45.5+/-9.6 yr). There were 293 cases of hyperhomocysteinemia (>14 microM/L) at follow-up. Increases in total body fat proportion and decreases in lean body mass (LBM) were significantly associated with increases in Hcy concentration after controlling for confounding factors. Further adjustments for behavioral factors showed that decreases in LBM were associated with Hcy increase. Decrease in LBM also predicted hyperhomocysteinemia at follow-up, after controlling for confounding factors. There was no significant association between change in body mass index (BMI) and Hcy concentrations over time. Hcy changes over time were related to change in LBM and body fat content, whereas BMI or weight change did not predict change in Hcy levels. Changes in ratio of LBM to total fat mass may contribute to hyperhomocysteinemia.

The Influence of Exogenous Fat and Water on Lumbar Spine Bone Mineral Density in Healthy Volunteers

PURPOSE: Changes in human body composition can affect the accuracy of spine bone mineral density (BMD) measurements. The purpose of this study was to evaluate whether fat and water in the soft tissue of the abdomen influence lumbar spine BMD measurements obtained using dual energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: Duplicate BMD measurements were carried out on healthy volunteers (10 men and 10 women) and the Hologic anthropomorphic spine phantom had on the same day before and after placement of following 3 materials in the abdominal area: lard 900 g, 1.5 cm thick; oil 1.4 liters in a vinyl bag; and water 1.2 liters in a vinyl bag. RESULTS: In the case of human participants, following the placement of exogenous water to mimic extracellular fluid (ECF), there was a significant decrease in lumbar spine BMD (-0.012 g/cm2, p=0.006), whereas the placement of exogenous lard and oil to mimic abdominal fat produced a slight increase in lumbar spine BMD (0.006 g/cm2, p=0.301; 0.008 g/cm2, p=0.250, respectively). The average percentage of lumbar spine BMD change with and without exogenous lard, oil, and water showed increase of 0.51%, and 0.67%, and decrease of 1.02%, respectively. Using the phantom, BMD decreased with the placement of both lard (-0.002 g/cm2, p=0.699) and water (-0.006 g/cm2, p=0.153); however, there was no difference in BMD after oil placement. CONCLUSION: These results suggest that in cases where changes in fat and ECF volume are similar, ECF exerts a greater influence than fat on DXA lumbar BMD measurements.

The Efficacy and Safety of a Combined Alendronate and Calcitriol Agent (Maxmarvil): A Postmarketing Surveillance Study in Korean Postmenopausal Women with Osteoporosis / 가정의학회지

BACKGROUND: Combined therapy with alendronate and calcitriol may have additive effects on bone density. An observational study was performed to evaluate the efficacy and safety of Maxmarvil, a combinative agent of alendronate (5 mg) and calcitriol (0.5 microg), and to identify factors associated with efficacy. METHODS: A total of 568 postmenopausal women with osteoporosis were enrolled by family physicians in 12 hospitals. The study subjects took Maxmarvil daily for 12 months. Questionnaires about baseline characteristics, socioeconomic status, and daily calcium intake were completed at the first visit. Adverse events were recorded every 3 months and bone mineral density (BMD) in the lumbar spine was measured using dual-energy X-ray absorptiometry at baseline and after 12 months. We evaluated the efficacy and safety of Maxmarvil, and the factors related to BMD improvement. RESULTS: A total of 370 patients were included in final analysis. The median BMD was 0.81 +/- 0.12 g/cm2 at pre-treatment and 0.84 +/- 0.13 g/cm2 after one year. The average BMD improvement was 3.4% +/- 6.4% (P < 0.05), and 167 (45.1%) patients showed improvement. Factors associated with improved BMD were continuation of treatment (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.15 to 5.07) and good compliance (OR, 2.54; 95% CI, 1.29 to 5.00). Adverse events were reported by 35 of the 568 patients, with the most common being abdominal pain and dyspepsia. CONCLUSION: Maxmarvil was found to be safe, well tolerated and effective in osteoporosis treatment. Continuation of treatment and good compliance were the factors associated with efficacy.

The Relation of Thyroid Function to Components of the Metabolic Syndrome in Korean Men and Women

This study was to assess the relation of thyroid dysfunction to metabolic syndrome (MetS) at an earlier stage in Korean population. Metabolic parameters such as body composition, blood pressure (BP), fasting glucose, total cholesterol, triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), thyroid-stimulating hormone (TSH) and free thyroxine 4 (fT4) were measured. During a mean follow-up of 3 yr, 5,998 Koreans ages over 18 yr were assessed. There were 694 cases of MetS at follow-up. The mean age of the subjects was 45.6 +/- 9.5 yr. Mean level of TSH was 2.02 +/- 1.50 mIU/L, mean level of fT4 was 1.23 +/- 0.20 rhoM/L. At baseline, TSH levels and fT4 levels were associated to waist circumference, BP, glucose and lipids in the subjects. Increase in systolic blood pressure, diastolic blood pressure (DBP), total cholesterol and TG were significantly associated with changes in TSH levels after adjustment. Changes in DBP, TG, HDL-C and fasting glucose were significantly associated with changes in fT4 levels after adjustment. Increase in TSH levels even after further controlling for baseline TSH level predicted the MetS over the study period. In conclusion, there is a relationship between thyroid function and cardiovascular risk factors, such as BP, total cholesterol, TG, HDL-C and fasting glucose. Also, higher levels of TSH may predict the MetS in Korean.

Carcinoembryonic Antigen Level Can be Overestimated in Metabolic Syndrome

Carcinoembryonic antigen (CEA) levels can be affected by many factors and metabolic syndrome is also a candidate. This study examined the relationship between CEA levels and metabolic syndrome using the data of 32,897 healthy Koreans. Fecal occult blood tests were also performed. Subjects with colorectal carcinoma were excluded. Subjects were classified by their smoking status, metabolic syndrome and its components. Prevalence of metabolic syndrome and its all components showed a significant increase according to the quartile of serum CEA concentration (P < 0.001). Increased numbers of metabolic syndrome components showed a positive association with CEA levels (P-trend < 0.001). The odds ratios for the highest CEA quartile vs the lowest serum CEA quartile significantly increased in the presence of metabolic syndrome and its components. After adjusting for age, gender and smoking status, metabolic syndrome, low high density lipoprotein cholesterol and elevated blood pressure had higher odds ratios (OR) of the highest CEA quartile compared with the lowest serum CEA quartile (OR = 1.125, 95% CI = 1.030 to 1.222, P = 0.009; OR = 1.296, 95% CI = 1.195 to 1.405, P < 0.001; OR = 1.334, 95% CI = 1.229 to 1.448, P < 0.001, respectively). These results indicate that metabolic syndrome is associated with CEA value, which may lead to a misunderstanding of the CEA levels.

Association of Cortisol and the Metabolic Syndrome in Korean Men and Women

Obesity and the metabolic syndrome are closely related and have become increasingly prevalent in Korea. The cardiovascular disease (CVD) risk factors comprising the metabolic syndrome have previously been associated with increased hypothalamic-pituitary-adrenal axis (HPAA) activity, but the associations have not been extensively examined in non-Caucasian populations. The aim of the present study was to investigate the relationships between cortisol, adiposity and the metabolic syndrome in a Korean population. A total of 1,881 adults participated in the study between January 2001 and February 2008. Sociodemographic data were assessed by questionnaires. Body composition, clinic blood pressures as well as metabolic variables including glucose, insulin, and lipid profile were assessed and analyzed in relation to cortisol levels. Mean age of the participants was 58.7 +/- 10.8 yr. Higher levels of cortisol was associated with elevated blood pressure, fasting glucose and total cholesterol in men, and between cortisol and systolic blood pressure, fasting glucose and total cholesterol in women. There was an increased risk for the metabolic syndrome associated with higher cortisol levels in both men (P < 0.001) and women (P = 0.040) adjusting for age and body mass index. Higher cortisol levels are associated with several CVD risk factors and the metabolic syndrome, independent of overall of adiposity level, in Korean men and women.

Vitamin K Supplement Along with Vitamin D and Calcium Reduced Serum Concentration of Undercarboxylated Osteocalcin While Increasing Bone Mineral Density in Korean Postmenopausal Women over Sixty-Years-Old

There are inconsistent findings on the effects of vitamin K on bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC). The present intervention study evaluated the effect in subjects over 60-yr-old. The vitamin K group (vitamin K + vitamin D + calcium supplement; 15 mg of vitamin K2 [menatetrenone] three times daily, 400 IU of vitamin D once a day, and 315 mg of calcium twice daily) and the control group (vitamin D + calcium supplement) were randomly assigned. During the six months of treatment, seventy eight women participated (38 in the vitamin K group and 40 in the control group) and 45 women completed the study. The baseline characteristics of study participants did not differ between the vitamin K and the control groups. In a per protocol analysis after 6 months, L3 bone mineral density has increased statistically significantly in the vitamin K group compared to the control group (0.01 +/- 0.03 g/cm2 vs -0.008 +/- 0.04 g/cm2, P = 0.049). UcOC concentration was also significantly decreased in the vitamin K group (-1.6 +/- 1.6 ng/dL vs -0.4 +/- 1.1 ng/dL, P = 0.008). In conclusion, addition of vitamin K to vitamin D and calcium supplements in the postmenopausal Korean women increase the L3 BMD and reduce the UcOC concentration.

Women with Fibromyalgia Have Lower Levels of Calcium, Magnesium, Iron and Manganese in Hair Mineral Analysis

Little is known about hair mineral status in fibromyalgia patients. This study evaluated the characteristics of hair minerals in female patients with fibromyalgia compared with a healthy reference group. Forty-four female patients diagnosed with fibromyalgia according to the American College of Rheumatology criteria were enrolled as the case group. Age- and body mass index-matched data were obtained from 122 control subjects enrolled during visit for a regular health check-up. Hair minerals were analyzed and compared between the two groups. The mean age was 43.7 yr. General characteristics were not different between the two groups. Fibromyalgia patients showed a significantly lower level of calcium (775 microg/g vs 1,093 microg/g), magnesium (52 microg/g vs 72 microg/g), iron (5.9 microg/g vs 7.1 microg/g), copper (28.3 microg/g vs 40.2 microg/g) and manganese (140 ng/g vs 190 ng/g). Calcium, magnesium, iron, and manganese were loaded in the same factor using factor analysis; the mean of this factor was significantly lower in fibromyalgia group in multivariate analysis with adjustment for potential confounders. In conclusion, the concentrations of calcium, magnesium, iron, and manganese in the hair of female patients with fibromyalgia are lower than of controls, even after adjustment of potential confounders.

The Relationship between Cigarette Smoking and Obesity in the Adolescents / 가정의학회지

BACKGROUND: The social problems of cigarette smoking and obesity are increasing and they threaten the health and daily life of the both the young and old adults. Therefore, we evaluated the relationship between cigarette smoking and obesity. METHODS: The study subjects were recruited from the middle and high school located in Ansan city. We used the self-questionnaire to evaluate their general information including cigarette smoking at enrollment and 8,589 students informations were gathered. Data were classified into three groups (normal body weight, over weight and obesity). Smoking status was classified into past, current, and non smoker and analyzed the relationship with obesity and some life-style patterns. RESULTS: Body weight and body mass index of the girls were significantly higher in the current smokers (52.4 +/- 12.2 kg, 19.8 +/- 3.5 kg/m2) than in the non-smokers (49.5 +/- 7.7 kg, 19.3 +/- 2.6 kg/m2) and in the boys, body weight was higher in the current smokers (60.3 +/- 10.7 kg, 20.4 +/- 3.1 kg/m2) than in the non-smokers (57.5 +/- 12.1 kg, 20.3 +/- 3.3 kg/m2), which was not significant. The odds ratios of having obesity were 2.33 (P < 0.001; 95% confidence interval [CI], 1.24 to 3.34) in the current smokers and 2.04 (P < 0.001; 95% CI, 1.36 to 4.0) in the past smokers compared with the non-smokers in the girls. In the boys, there were no significance. Also, all students of the dietary pattern (breakfast, fast food, instant noodle, snack, soft drink) were associated with smoking status significantly. CONCLUSION: The current smokers showed higher prevalence of obesity and obesity-related dietary pattern than in the non-smokers. Cigarette smoking may be associated with obesity in the school girls.

The Relationship between Cigarette Smoking and Obesity in the Adolescents / 가정의학회지

BACKGROUND: The social problems of cigarette smoking and obesity are increasing and they threaten the health and daily life of the both the young and old adults. Therefore, we evaluated the relationship between cigarette smoking and obesity. METHODS: The study subjects were recruited from the middle and high school located in Ansan city. We used the self-questionnaire to evaluate their general information including cigarette smoking at enrollment and 8,589 students informations were gathered. Data were classified into three groups (normal body weight, over weight and obesity). Smoking status was classified into past, current, and non smoker and analyzed the relationship with obesity and some life-style patterns. RESULTS: Body weight and body mass index of the girls were significantly higher in the current smokers (52.4 +/- 12.2 kg, 19.8 +/- 3.5 kg/m2) than in the non-smokers (49.5 +/- 7.7 kg, 19.3 +/- 2.6 kg/m2) and in the boys, body weight was higher in the current smokers (60.3 +/- 10.7 kg, 20.4 +/- 3.1 kg/m2) than in the non-smokers (57.5 +/- 12.1 kg, 20.3 +/- 3.3 kg/m2), which was not significant. The odds ratios of having obesity were 2.33 (P < 0.001; 95% confidence interval [CI], 1.24 to 3.34) in the current smokers and 2.04 (P < 0.001; 95% CI, 1.36 to 4.0) in the past smokers compared with the non-smokers in the girls. In the boys, there were no significance. Also, all students of the dietary pattern (breakfast, fast food, instant noodle, snack, soft drink) were associated with smoking status significantly. CONCLUSION: The current smokers showed higher prevalence of obesity and obesity-related dietary pattern than in the non-smokers. Cigarette smoking may be associated with obesity in the school girls.

The Relationship between Daily Calcium Intake and Plasma Homocysteine Concentrations in Adults / 가정의학회지

BACKGROUND: Elevated plasma total homocysteine causes the risk of cardiovascular diseases. By reducing plasma total homocysteine may prevent cardiovascular diseases. Many studies showed that vitamin B12 and folic acid decrease homocysteine level when taken with calcium fortified drinking water. Our aim of this study was to demonstrate the association between plasma homocysteine concentrations and daily calcium intake. METHODS: Among 636 adults aged 40-69 years who visited a health promotion center of a university hospital from May 2006 to April 2007, the study subjects were 567 who completed self-reported questionnaire. Self-reported calcium intake amount and their baseline health questionnaire were obtained. We measured height and weight by physical examination. Through blood test, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, plasma creatinine and homocysteine level were evaluated. RESULTS: The mean daily calcium intake of entire subjects was 770.1 +/- 266.3 mg. The mean plasma homocysteine concentration was 10.6 +/- 4.3 micromol/L. The multiple regression analysis showed significant correlations between plasma homocysteine level and body mass index, plasma creatinine level and calcium intake. Plasma homocysteine level was inversely associated with dietary calcium intake. CONCLUSION: We found the calcium was inversely associated and homocysteine level an independent risk factor of cardiovascular diseases. However, further studies should be established to confirm if greater calcium intake may lower plasma homocysteine level.

Depression and Its Infl uencing Factors among Korean Medical and Engineering Students in Urban Areas using Zung Self-Rating Depression Scale / 가정의학회지

BACKGROUND: It is a well known fact that students majoring in medicine and engineering suffer from higher stress level and depression than students in other majors. This study was done to assess the prevalence of depression and the infl uencing factors among the university students majoring in either medicine or engineering and to compare the depression prevalence between the two groups. METHODS: The study randomly selected 640 students either majoring in medicine or engineering from two universities in Kyung-Gi province, Korea. Each of 320 students majoring in either of the two majors from each university was recruited. Among 640 students, 360 students, who were composed of 172 medical students and 188 engineering students was finally chosen for the analysis. The Zung Self-Rating Depression Scale was used to measure the depression state. RESULTS: The average Zung depression score of university students was 49.2 alpha 9.8. Medical students had a higher score of 52.4 alpha 9.3 as compared to engineering students, who scored 46.3 +/- 9.4. Overall depression rate was 42.8%. Medical students had a higher depression rate (52.3%) than engineering students (34.0%). The logistic analysis showed that infl uencing factors on depression state were sex, grade, major, stress and satisfactory sleep. The main source of stress for medical students was the grades from classes whereas job search was for engineering students. There were differences between the two groups in managing the stress. Medical students chose alcohol drinking or smoking for stress management whereas engineering students playing selected video games as their outlet. CONCLUSION: Medical students from urban areas seemed to be depressed more than engineering students. Their stress management methods among the subjects were drinking, smoking, and playing video games which may cause further physical and psychological problems in the future.

The Relationship between High-sensitive C- reactive Protein and Different Obese Types in Middle-aged Koreans

BACKGROUND: Obesity and metabolic syndrome are closely correlated where previous studies showed that adipocytes release many inflammatory substances. HsCRP is an indicator of an independent risk factor in coronary heart disease. The aim of this study was to investigate the difference of hsCRP in different types of obese patients. METHODS: We analyzed the data of 7,183 middle-aged Korean adults between the ages of 40 and 60 (men 4,147 and women 3,036) by using a cross-sectional approach. We divided study subjects into 4 different groups; Normal Group (NG; normal waist and normal body mass index), Centrally Obese Group (OB1; Non-obese group with central obestiy), Obese Group without central obesity (OB2) and Obese Group with central obesity (OB3). We compared the difference of anthropometry, metabolic parameters, and hsCRP. RESULTS: Waist circumference (r=0.230, P<.001) and body mass index (r=0.222, P<.001) positively corresponded with high levels of hsCRP. Higher values of hsCRP were found in the OB3 compared to the NG. However, there was no difference between the OB1 and the OB2. The subjects who had central obesity or the metabolic syndrome showed high hsCRP values. The hsCRP values were the highest in subjects who had central obesity with the metabolic syndrome. But, the value of hsCRP was not significantly different in central obesity subjects with or without the metabolic syndrome. CONCLUSION: The highest value of hsCRP was significantly shown in the obese group with central obesity. However, there were no differences found in the hsCRP levels between the non-obese group with central obesity and the obese group without central obesity.

Impact of Smoking and Alcohol Intake on Bone Mineral Density in Men

BACKGROUND: Smoking may be a factor that decreases bone mineral density. Alcohol also may be a factor that increases or decreases bone mineral density. The authors investigated the relationship among life style-related smoking and alcohol intake and the bone mineral density and the amount that may result in the incidence of osteoporosis in Korean men over forties. METHODS: In 1,650 men over forties, we compared the mean values of bone mineral density by factors. Multiple logistic regression analysis was done on the incidence of osteoporosis and the statistically significant factors after adjustment for age, body index, and daily activity. RESULTS: In men, who smoked over 30 pack-years, the bone mineral density of the spine (P<.001) and the femur (ward; P=.001, neck; P=.003) was statistically significantly low before and after adjusting (spine P=.001, femur ward P=.010, femur neck P=.016) for age, body mass index, and daily activity. In men who were presently drinking alcohol, the bone mineral density of the femur increased significantly (P<.001), but drinking alcohol only influenced the bone mineral density of the femur neck after adjustment (P=.025). In men who drank 200~300 g per week, the bone mineral density of the femur increased significantly (ward P=.001, neck P<.001), and it influenced the bone mineral density of the femur neck (P= .046) after adjustment. The odds ratio was 1.5 in men who smoked over 30 pack-years in the incidence of osteoporosis, and was statistically significant. CONCLUSION: As the odds ratio for incidence of osteoporosis increased in men who smoked over 30 pack-years, it is important to stop smoking.

The Relation of Cardiovascular Risk Factors to Metabolic Syndrome

BACKGROUND: Possible risk factors relating to the development of insulin resistance was analyzed and the clinical availability of metabolic syndrome on insulin resistance was examined to evaluate the relationship between the metabolic syndrome and insulin resistance. METHODS: A total of 993 clients were selected according to the criteria of clinical identification by NCEP-ATP III. The metabolic syndrome group was 502 subjects and the control group was 491 subjects. Sociodemographic data and lifestyle factors were surveyed by questionnaire. Height, weight, blood pressure, fasting blood cholesterol, triglyceride, HDL cholesterol, glucose, and insulin levels were measured. W/BH ratio, AI, and HOMA-IR were calculated and analyzed in relation to cardiovascular risk factors. RESULTS: In the metabolic syndrome group, men were significantly greater than women (P<0.05). The mean age and BMI in the metabolic syndrome group were significantly higher than controls (P<0.05). The cut-off point for cardiovascular risk factor using the ROC curve with W/BH ratio was 0.529, AI 4.34, HOMA-IR 1.94, and Insulin 6.35 uIU. The area under the ROC curve for variables was significantly greater than the reference value (P=0.000). Therefore, W/BH ratio was a strong predictor of incident metabolic syndrome. The study subjects were grouped according to insulin resistance and then the relationship of cardiovascular risk factors was evaluated. Odds ratios of hypertension, hypertriglyceridemia, and low HDL-cholesterolemia were significantly increased in the metabolic syndrome group (P<0.05), while the individuals with insulin resistance had a much higher incident diabetes than those without it, regardless of whether NCEP criteria for metabolic syndrome was met. The risk of insulin resistance in relation to metabolic risk factors tended to increase after adjustment of life style factors. CONCLUSION: The diagnostic criteria for the metabolic syndrome was useful in finding out early stage of insulin resistance as an indirect measurement tool. Incident diabetes related to insulin resistance regardless of the presence of metabolic syndrome. Therefore, clinical treatment and life style modification in metabolic syndrome patients may decrease the development of cardiovascular disease and contribute to health promotion. Further study is needed to follow-up on metabolic syndrome patients.

Four Cases of Staphylococcal Scalded Skin Syndrome / 소아과

Staphylococcal scalded skin syndrome is a systemic disease with a clinical spectrum ranging from subcorneal pustules, patterned exfoliation to extensive erosion and peeling of skin by the exfoliative toxin of group II Staphylococcus aureus. This disease occurs mainly in infancy and children below five years and it isn't easy to differentiate from other vesicular diseases clinically, but skin biopsy shows an epidermal split at the granular layer. The form and severity of staphylococcal scalded skin syndrome will vary according to defense system and toxic factors. Treatment is effective antibiotics, and the mortality rate increases to 5% in children. In our four cases, symptoms were erythema and fever, followed by formation of large bullae and denuded skin. On laboratory findings, leukocytosis was noted in three cases, and S. aureus was confirmed by culture of eye discharge in all cases. Our cases improved with antibiotic therapy. We experienced four cases of staphylococcal scalded skin syndrome which were presented with vesicle and exfoliative skin lesion and treated successfully.

The Clinical Significance of Increased Prostate Specific Antigen Concentration in Routine Check-Up

BACKGROUND: As prostate cancer in men is increasing in Korea, the need for early detection by mass screening has become an important issue. Screening tests for early detection of prostate cancer are digital rectal examination, transrectal ultrasonography (TRUS) and prostate specific antigen (PSA) test. PSA test has been mainly used for prostate cancer screening in health promotion centers. However, PSA has a high sensitivity but low specificity. Therefore, PSA concentration can be increased not only in prostate cancer, but also in several benign prostate diseases such as benign prostate hyperplasia (BPH), prostatitis, and prostate ischemia. Also, PSA concentration can increase in the elderly. Therefore, we investigated the results of follow-up PSA tests, in the cases of increased PSA concentration on screening. METHODS: In 538 cases, the PSA concentration were increased over 2.5 ng/ml among total 17,302 males checked up on screening test at Ajou University Hospital from January 1999 to December 2001. Two hundred and four cases followed up with TRUS or prostate biopsy were chosen. We investigated 89 cases who performed follow- up PSA test. On the basis of the results of biopsy or TRUS, the subjects were classified into non-disease group, benign prostate disease group and prostate cancer group (possible or confirmed prostate cancer group). RESULTS: The mean age of non-disease group was 35.5 5.9 years, which was significantly lower than that of benign prostate disease group and prostate cancer group (P<0.05). Compared to the mean age of prostate cancer group (60.6 10.4 years) and non-prostate cancer group (53.1 12.3 years), prostate cancer group was significantly older than non prostate cancer group (P=0.005). When the lower limit of age was set to 40 years (mean-2SD), confirmed prostate cancer group was significantly older than other groups (p<0.001). The PSA concentration of confirmed prostate cancer group (11.33 7.58 ng/ml) was significantly higher than that of non-prostate disease group (4.35 2.22 ng/ml) and possible prostate cancer group (4.44 2.29 ng/ml) (P<0.05). The follow-up PSA level of confirmed prostate cancer group (10.13 6.13 ng/ml) was significantly higher than that of non-prostate disease group (2.55 0.97 ng/ml), BPH group (4.33 3.80 ng/ml), prostatitis group (3.61 2.17 ng/ml), prostate cyst group (3.00 1.86 ng/ml) and possible prostate cancer group (3.81 2.82 ng/ml) (P<0.05). CONCLUSION: It is recommended that screening test for prostate cancer be performed after the age of 40. While follow-up PSA test is needed when the PSA is increased up to less than 10 ng/ml, prostate biopsy may be desired in the PSA value of 10.0 ng/ml or greater.

Recognition status of health related to smoking, alcohol drinking, and stress in a working place

BACKGROUND: This research has been performed to recognize their current attention on the purpose further improvement and management of health understanding co - relation between working and stress through the survey of smoking and alcohol drinking as an object of salary men and women. METHODS: The questionnaire toward the their general situation and interest of health status (smoking alcohol drinking, stress, joy and sadness) was distributed and surveyed as an object of full members of hospital which is located at Suwon in 1999. The form of the Questionnaire was comfortable answer, multiple choice which was composed of 125 question. The object of survey was all members of hospital (about 1940 person). However, finally 483 person was recommended among collected 492 pieces out of distributed 600 pieces. RESULTS: The age range of objects was 21-64 years old. Average age was 31 years old, male was 175 persons (36.2%) and female was 308 persons (63.8%). Smoking rate per sex was that female was 2 Person (0.7%) among 299 persons and male was 118 person (68.2%) among 173 persons. Thirties of age group was the most majorities as 78 person among 120 smokers. The reason for smoking is that habit was 79 persons (52.0%) next to relief of stress was 51 persons (33.6%). There was significant differences (p<0.05) whether present health due to smoking affects future health Alcohol drinking rate is 75.937f (30 poisons). There is no sexual differences. (M: 76.3%, F: 75.7%) Dining together a primary reason of alcohol drinking is 222 persons (65.1%), next to stress is 92 persons (27.0%). 146 persons considered that alcohol drinking is helpful for life. However 63 persons (19.67f) was concerned that alcohol drinking affected health and 197 persons (61.6%) agreed that alcohol drinking affected health not now for the future. It is proved that there is significant differences whether present status of health affects future one of those.356 patients (78.5%) answered that they are stressed at present showed especially significant high rate to female (p<0.01). 287 Patients (64.37) considered that there is an abnormal symptoms due to stress. There is significant relation between stress and health (r =0.46, p<0.01). 279 persons answered that company is an object of stress whether 48 persons is family as that. 322 persons (74.4%) considered that stress of working (family) affects family (working) showed that there is significant differences (p<0.01).353 persons (83.57) answered that stress is worst to health among stress , smoking, alcohol drinking. However, it is not significant differences statistical that there is relation between stress, smoking, alcohol drinking by sex and age. CONCLUSION: Stress was no relation to smoking and alcohol drinking. It might be considered that stress is worst to health than smoking and alcohol drinking. It affects health abnormally.