Development and validation of a simple index system to predict nonalcoholic fatty liver disease / 대한간학회지

BACKGROUND/AIMS: Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model. METHODS: The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system. RESULTS: Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; gamma-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m2< or =BMI<25 kg/m2 (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m2 (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively. CONCLUSIONS: NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.

Activities of Daily Living and Health-Related Quality of Life HRQoL of Centenarians in Busan / 기본간호학회지

PURPOSE: The aim of the study was to identify the relationships among age, activities of daily living and health-related quality of life (HRQoL) for centenarians in Busan. METHODS: Forty-nine centenarians (2 males and 47 females) participated in the study, done from April to July, 2006. Pace-to-face interviews were used to collect data. Activities of daily living were measured using K-ADL, K-IADL and health-related quality of life, using the Short Form Health Survey (SF-36). RESULTS: Over 50% of the centenarians reported independence for six-items but not for bathing. With regard to type of dependency, 77.6% were independent in transferring, 71.4%, in using the toilet, 67.3%, in feeding and in continence and 57.1% in dressing but just 24.5% were independent in bathing. Age was significantly associated with K-IADL (r= -.303, p= .03). The centenarians were more impaired in physical health components compared to mental health components for health-related quality of life. CONCLUSION: These results may contribute to a better understanding of activities of daily living and health-related quality of life of centenarians. The findings are relevant to health professionals, in particular professionals who are developing wellness programs to optimize health-related quality of life and functional status for the extremely old age population.

The Experience of Teaching Emergency Management and Cardiopulmonary Resuscitation to Medical Students in Busan / 한국의학교육

PURPOSE: The aim of this study was to describe the experience of teaching emergency management and cardiopulmonary resuscitation to medical students in Busan. METHODS: Study participants were 59 medical students in Busan. An eight-day curriculum in the emergency management and cardiopulmonary resuscitation was developed. They completed all class sessions and two drill/practical examinations taught by our interdisciplinary team from July 21 through 30, 2003. Each class is approximately 2 hours and reading assignments are given at the end of each class. Also included are practical, table-top and team-building exercises. The participants completed self-reported questionnaires for the education. RESULTS: About establishment and environment of the education, respondents answered with `very good' were 14%. About overall theoretical lecture, respondents answered with `very helpful' were lower than 40%. Especially, favorable evaluation for the medical lectures was lower than that of other lectures. Students generally enjoyed their emergency medicine experience as it is often their first opportunity to assume primary responsibility for patient care. About overall practices, respondents answered with 'very helpful' were higher than 60%. CONCLUSION: The authors found that medical students prefer opportunities to hone procedural skills than to hear theoretical lectures. Also, medical students are welcome to hear theoretical lectures that consists of emergency management related contents, not academically medical contents. This curriculum should be tailored to fulfill learner's requirements.