Résumé
BACKGROUND: Many studies to reduce serum lipoprotein(a) are done because serum lipoprotein(a) has been known to be an independent risk factor of coronary artery disease along with age, smoking, diabetes, hypertension, and hyperlipidemia. Till now, oral estrogen/androgen therapy, niacin analogue and plasmapheresis are known therapeutic methods. This study examined the relative effects of three antihyperlipidemic agents, acipimox, lovastatin, fenofibrate. METHODS: Among 70 subjects (male-19, female-51) with their serum cholesterol level of more than 240mg/dL, 56 subjects who were completed 2 months antihyperlipidemic treatment (acipimox-20, lovastatin-18, fenofibrate-18) were examined for baseline total cholesterol, HDL cholesterol, triglyceride, and lipoprotein(a) and were followed up 2 months later. RESULTS: Mean values of each group for acipimox, lovastatin, fenofibrate were as follows: total cholesterol (268.1+/-19.03, 287.1+/-36.42, 268.9+/-25.99), HDL cholesterol (43.5+/-10.99, 42.7+/-11.88, 37.9+/-8.20), triglyceride (226.1+/-165.03, 260.4+/-175.98, 234.3+/-124.33), LDL cholesterol (179.3+/-30.40, 192.3+/-41.52, 184.1+/-38.08), lipoprotein(a) (26.2+/-15.32,34.8+/-18.56,29.9+/-12.58). Mean percentile reduction of lipoprotein(a) was acipimox-41.4%(P<0.0001), lovastatin-22.2%(P<0.0001), fenofibrate-16.1%(P<0.05), and p value was less than 0.05 in the comparison of groups. Lipoprotein(a) showed no relations with age, sex, BMI, WHR, smoking, total cholesterol, HDL cholesterol, triglyceride and LDL cholesterol. After 2 months treatment, mean reduction percentages of total cholesterol was acipimox-12.2%(P<0.0001), lovastatin-17.6%(P<0.0001), fenofibrate-8.85%(P<0.05). LDL cholesterol was acipimox-16.12%(P<0.0001), lovastatin-22.89%(P<0.0001), fenofibrate-12.06% (P<0.05). Triglyceride was acipimox-17.24%(P<0.0001), lovastatin-17.39%(P<0.0001), fenofibrate-9,78%(P<0.05). HDL cholesterol was elevated in acipimox-17.24%(P<0.05), lovastatin-16.10%(P<0.05) and fenofibrate-12.06(P<0.05). In total cholesterol(P<0.05) and LDL cholesterol(P<0.05), there were significant differences among 3 groups, but not in HDLcholesterol and triglycerides. CONCLUSION: In two months treatment of acipimox, lovastatin and fenofibrate in hyperlipidemic patients, lipoprotein(a), known for independent risk factor of coronary artery disease, was reduced significantly in the order of acipimox, lovastatin and fenofibrate.
Sujets)
Humains , Cholestérol , Cholestérol HDL , Cholestérol LDL , Maladie des artères coronaires , Fénofibrate , Hyperlipidémies , Hypertension artérielle , Lipoprotéine (a) , Lovastatine , Acide nicotinique , Plasmaphérèse , Facteurs de risque , Fumée , Fumer , TriglycérideRésumé
BACKGROUND: This study was conducted to evaluate belief and practice levels of family physicians concerning primary care is settled or not. METHODS: The target population were those family physicians having finished their three-year residency course in family medicine after 1989. Out of 2,075 people, the addresses 945were identified of This was a sample population. We exckyded 63persins who worked in medical school. The questionnaires were sent twice during July to September in 1998, and contents were constructed if general characteristics, items of belief and practice level of five areas of primary care(1977, IOM - Accessibility, Comprehensiveness, Continuity, Coordination, Accountability). RESULTS: Response rate was 32.1%(total : 270 : 1st respondents : 226 and 2nd : 44). Average belief level concerning principles of primary care was 4.45 point(5 point scale), and according to area rate continuity, coordination, comprehensiveness, accountability which was significant(p=0.00). Average practice level(5 point scale) concerning principles of primary care was 3/64 point. In order of strength of belief : accessibility, comprehensiveness, coordination, accountability, continuity, which was significant (p=0.00). The highest concordance between belief and practice was accessibility(p=0.00) and the highest gap was continuity(p=0.00). Compared with the unsatisfied group, the satisfied group had higher practice level(p=0.00). Significant variables that affect practice level were belief level, opening, satisfaction(r2=0.27, p=0.00). The opinion of whether primary care was settled was mostly negative(95.8%). CONCLUSION: Although, family physicians were revealed to have relatively high belief and practice level concerning primary care, their opinions about primary care setting werew negative. There is a lot of significant gap between individual level as family physician and societal level in primary care. More studies need to be conducted to determine the causes of such difference.
Sujets)
Humains , Enquêtes et questionnaires , Besoins et demandes de services de santé , Internat et résidence , Médecins de famille , Soins de santé primaires , Écoles de médecine , Responsabilité socialeRésumé
BACKGROUND: Smoking is a very dangerous behavior and people know that it will lead to fatal health problems. But, many people continue to smoke. We studied psychiatric aspect of smoking. METHODS: We distributed self-questionnaire to people who visited Dong-San Medical Hospital for periodical examination and checkups between the months of April and June, 1996. It consisted of inquiries on their smoking status and symptom check list for minor psychiatric disorders(SCL-MPD). Among the total of 147 men 58 were current smokers, 63 non-smokers, 26 ex-smokers. We compared minor psychiatric differences between each groups by Student t-test. RESULTS: The mean age of current smokers, ex-smokers and non-smokers were 44.9 +/-8.9, 44.8+/-8.4 and 46.6+/-9.6, respectively. Among 10 dimensions of SCL-MPD, the smokers (includes current smokers and ex-smokers) had significantly higher scores on anger-hostility, interpersonal sensitivity and obsessive-compulsive dimensions than those of non-smokers(p<0.05). When comparing with current smokers and non-smokers, current smokers had significantly higher scores on anger-hostility and obsessive-compulsive dimensions(p<0.05). Between ex-smokers and non-smokers, ex-smokers had significantly higher scores on anger-hostility and obsessive-compulsive dimensions(.p<0.05). But, no significant differences were observed between current smokers and ex-smokers. CONCLUSIONS: Smokers(current smokers and ex-smokers) were highly associated with anger-hostility, interpersonal sensitivity and obsessive-compulsive disorders compared to non-smokers. But, no minor psychiatric differences were observed between current smokers and ex-smokers.
Sujets)
Humains , Mâle , Comportement dangereux , Trouble obsessionnel compulsif , Fumée , FumerRésumé
BACKGROUND: A child battering can lead to a serious obstacles to the development in mental, physical and social life. Also it can produce an impediment to a domesticity. A child battering has been studied in Seoul, but there has been little study on the frequency and the relat,ed factors according to t,he region. Therefore, this study was carried out to investigate the frequency and the related factors with a child battering in urban and rural areas. METHODS: A questionnare survey was conducted on 1,652 children in 3rd 4th grade of two elementary school(one urban area and the other in suburban area) in Taegu and one school in rural area of Kyungbook province from September 1 to September 10 1995. The children were grouped by Straus CRT scale according to the degree of battering. RESULTS: Among 1,652 surveyed children 1,196(72.4% ) children belonged to the battered group. 277(23.2%) children in the battered group belong to light battered group and 919(76.8%) children belong to the severely battered group. the common reasons for severe battering were making troubles(47.9%), poor school performance(16.5%) and disobedience t,o the parents(9.2 %). The primary battering persons are biologic mother(57.5%) and biologic father(25.7%), a rod is mainly used(72.2%). The frequercy of severely battering was significant,ly higher in the following cases; living in suburban(78.8%), middie school graduation in fathers education level (89.3%), high school graduation in mot,her's educat.ion level(84.9%), laborer(22.0%) or salary worker(20.9%, P<0.05). The level of battering was signficantly higher in urban and sunuban areas t.han in rural areas(P<0.05), also the cases of significantly high battering level were as followings; in suburban areas, fat,her only working(55.7%), both parents working(34.5%), laborer in father's occupation(22.0%), one or two times quarreling an year between father and mother(39.4%). 7 to 11 battering times an year(P<0.05%). However, the level of battering was not signficantly different among grade, sex, house type or religion. Majority of the physical injuries due to battering were no marks(60.7%) and bruise(31.5%). The most of the symptoms from severely battered were tingling sensation of extremities(51.6%) and a poor appetite(11.5%). The common psycho-behavioral complaints of the severely battered children were unamusing(30.9%), don't like studying or going to school(34.8%), dont like going home(12.8%). CONCLUSIONS: When diagnose and treat in family office, family physician must assess the family function that included a place of residence, the type of house, parents education, occupation and a religion, must affiliate a wound that, dont exposed in physical examination. Also standardized and verified physical violence for child abuse and battering child is necessary to be studied in Korea.
Sujets)
Enfant , Humains , Maltraitance des enfants , Éducation , Pères , Corée , Professions , Parents , Examen physique , Médecins de famille , Salaires et prestations accessoires , Sensation , Séoul , Violence , Plaies et blessuresRésumé
BACKGROUND: The interest of medicine was moved from disease treatment to disease prevention and health promotion. Especially, there has been marked increased interest in health promotion recently. Perception and health behaviors held or acquired during medical training can influence the acceptance and prevention strategies. This exploratory study surveyed medical and non-medical student to assess both preventive health behaviors and perception, to find relations of personal behaviors and corresponding perception. METHODS: This survey were conducted 140 medical students and 131 non-medical students in one big city. Data were obtained by self-reported questionnaire. Weschler survey was adapted to assess perception toward preventive behavior, and Fantastic lifestyle was adapt,ed to assess health behavior. RESULTS: Among the questionnaire of perception of preventive behavior, quitting cigarette smoking ranked highest frequency as very important in medical student. In non-medical student, use seat-belt is ranked highest frequency. Mean score of FANTASTIC lifestyle is 29.98 in medical student, 28.86 in non-medical. The result show significant relationship between st,udent-reported behavior and corresponding perception in 6 qestionnaire that is eat breakfast, moderate or no alcohol use, eliminate smoking, use seat belt, limit coffee, get seven hours sleep. CONCLUSIONS: In comparing medical and non-medical students, health perception and health behavior were no significant difference. Overall, the result indicated that the preponderance of respondents that is engaging in health behaviors are high in health perception.
Sujets)
Humains , Petit-déjeuner , Café , Enquêtes et questionnaires , Comportement en matière de santé , Promotion de la santé , Mode de vie , Ceintures de sécurité , Fumée , Fumer , Étudiant médecineRésumé
BACKGROUND: The prevalence of cognitive impairment in the elderly has been increasing in recent years with the growing of the aged population. Clinical assessment of cognitive function and mood is very important because cognitive impairment and depression commonly coexist in the elderly. The elderly interacts with the other family members, so cognitive impairment of the elderly influence family function. The objectives of this study were to delineate the factors correlated with cognitive function and to explore the relationship of depression and family function with cognitive function. METHODS: This study was done during 20 day period from July to August, 1996. The subjects were home residents aged 60 years or more living in a subcounty of Kyungpook Province, Korea. The final analysis included 195 subjects(male 95, female 100). The questionnaire included sociodemographic data, MMSE-K(Korean version of Mini Mental State Examination) for evaluation of cognitive function, BDI for evaluation of depression and family APGAR score for evaluation of family function. The results were analyzed by descriptive, comparative and correlative analysis. RESULTS: Mean MMSE-K score was 25.3+/-4.3 with female subjects(23.9+/-4.8) having significantly higher cognitive impairment when compaired to male subjects(26.6+/-3.2)(P<0.001). MMSE-K score was associated with gender, age, year of education(P<0.001), BDI and APGAR score(P<0.05). Religion, smoking and alcohol use were not associated with MMSE-K score. The prevalence of dementia by MMSE-K was 9.7% in definite dementia (MMSE-K<_19) and 23.1% with questionable dementia(20<_MMSE-K<_23). In male, the prevalence was 1.1% and 20.0% respectively. In female, the prevalence was 18.0% and 26% respectively, indicating difference between male and female subjects(P<0.001). CONCLUSIONS: In the elderly, female gender, older age and lower educational level were associated with cognitive function impairment. There was a positive correlation between cognitive function and family function. The group with impaired cognitive function had more depression than the normal group.
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Score d'Apgar , Démence , Dépression , Corée , Prévalence , Fumée , Fumer , Enquêtes et questionnairesRésumé
Allergy was originally defined in 1906 in 1906 by Clemens von Pirquet as 'altered reactivity' to denote the different reaction which on second exposure to and antigen due to the formation fo antibodies, when compared to the first exposure. The term atopy decribes the clinical presentation of Type I hypersensitivity, which include asthna, eczema, hay fever and urticaria, These usually occur in subjects with a family history of these or similar conditions. The mechanism of allergy is the Type I hypersensitity reaction. contact with allergen results in its being processed by an antigen presenting cell and presented to T helper cells which then help B cells to IgE antibody. The IgE antibody is rapidly taken up via its Fc portion by mast cells and basophils, which are then senitized. Subsequent contact with same allergen will result in the cross-linking of IgE molecules by their fab portions which cause cell degranulation and mediator release. The contribution of genentic factors to the development of atopy has been an intriguing issue. The exact controlling mechanisms of the genetic factors are unknown, but there are many studies support the genetic controls of the development of atopy. Abnormally high levels of IgE synthesis and associated atopy often run in families. Althouth the full inhritance pattern is probably multigenic, family studies has shown that their is clear autosomal transmission of atopy. The ability to make specific IgE antibodies to certain antigens, e.g., ragweed pollen, is also inherited and may be linked to particular class II major histocompatibility complex alleles. Therefore, I think that the clinicians must consider the environmental and genetic factors when evaluate the atopic disease.
Sujets)
Humains , Allèles , Ambrosia , Anticorps , Lymphocytes B , Granulocytes basophiles , Dégranulation cellulaire , Eczéma , Génétique , Hypersensibilité , Hypersensibilité immédiate , Immunoglobuline E , Complexe majeur d'histocompatibilité , Mastocytes , Pollen , Rhinite allergique saisonnière , Lymphocytes T auxiliaires , UrticaireRésumé
A clinical review was done on 343 infants and children diagnosed and operated at the Department of Pediatric Surgery in Keimyung University, Dong San Medical Center for congenital gastrointestinal anomalies from January, 1988 to December, 1991. The results are summarized as follows; The most prevalent age group of congenital gastrointestinal anomaly was within first week after birth, and infants within 3months occupied 70% of total, and male to female ratio was 2:1. 2) The moat common lesion of congenital gastrointestinal anomalies was stomach with 87cases (25.4%), followed by anus with 80 cases (23.3%), colon with 63 cases (18.4%) and biliary tract with 38 cases(11.1%). 3) The most common congenital anomaly was congenital hypertophic pyloric stenosis with 87 cases (25.4%), followed by imperforate anus with 70 cases (20.4%), congenital megacolon with 63 cases (18.4%), and prevalent age was 2 week-3month, first week after birth, 1month-3year. 4) The incidence of common congenital gastrointestinal anomalies were mostly higher in male than in female but choledochal cyst was higher in female than in male. 5) Associated anomalies were observed in 14 cases (4%) of total cases, duodenal atresia was seen the highest rate of the associated anomalies and the most common associated anomaly was annular pancreas, followed by Down syndrome, congenital diaphragmatic hernia.
Sujets)
Enfant , Femelle , Humains , Nourrisson , Mâle , Canal anal , Imperforation anale , Voies biliaires , Kyste du cholédoque , Côlon , Syndrome de Down , Hernie diaphragmatique , Maladie de Hirschsprung , Incidence , Pancréas , Parturition , Sténose du pylore , EstomacRésumé
No abstract available.