The relationship between osteoarthritis and bone mineral density in the lumar spine

BACKGROUND: Osteoporosis is becoming major health problem in old age and menopausal women, and osteoarthritis is most common joint disease in both ages. The inverse relationship between osteoporosis and osteoarthritis was first noticed 20years ago. However the subject had not been studied in korea. Thus, our objectives is to examine the influence of osteoarthritis on bone density measurements. METHODS: The study group consisted of 120 women, aged over 40 years, who visited for health examination in Health Center of Poondang Jesaeng general hospital from October 1998 to April 1999. Bone mineral density(BMD) of the lumar spine was measured, using dual energy X ray absorptiometry(Lunar, Expert XL), and lateal lumbar spine radiograph was taken. Severity of osteoarthritis were scored on osteophytes, disk space narrowing and vertebral body sclerosis. RESULTS: Postmenopausal women had signifcantly lower BMD than premenopausal women(p<0.001). Age(r= 0.545, p<0.001), body mass index(r=0.264, p<0.01) and education(r=0.284, p<0.01) were significantly correlated with BMD, but smoking, exercise, radiogrphic OA variables not correlated. However, stepwise multiple regression analysis using osteoporosis related variables and OA variables is indicated that menopausal status, body mass index, age, osteophytes were significantly associated factor with BMD, and lumbar osteophytes explained 2.7% of variation in lumbar spine BMD. CONCLUSION: We conclude that, among women, lumbar BMD is highier in those with osteophytosis of the lumbar spine. The effect is largely directed by osteophytes being included in the BMD measurement.

A Study of the core curriculum of family medicine residency Program in Korea

BACKGROUND: In order to provide basic data which are necessary for the standard reference of residency training program in family medicine, we analysed of family practice residency program in Korea(the core curriculum) which has 313 items - diseases and problems - proposed by the Korea Academy of Family Medicine. METHOD: Each items of the core curriculum of family practice residency program In Korea were sorted according to ICD-10. They were the mogt compared to common 100 diseases and clinical cases in family medicine department. of a tertiary hospital in one year. The most common 100 diseases were listed according to ICD-10, also. But some items which were difficult to sort were excluded. Eighty eight types of diseases were sorted.7inical data of a tertiary hospital included 9138 cases. RESULTS: Comparing to clinical cases of a tertiary hospital, the core curriculum includes 93.2% cases of family medicine department of a tertiary hospital. Among the 17 fields of the core curriculum, 12 fields were found in about 50% or more among cases of the clinic and 5 fields were in less than 50% Among 88 diseases, the core curriculum includes 78 diseases. 10 diseases were excluded. In the most common 100 diseases, 12 diseases were related to trauma and the core curriculum did not include them. CONCLUSION: Generally the core curriculum included highly prevalent diseases, but did not include some diseases which is important. Revision to make up for the weak points in the current core curriculum may be necessary.

Estimation of Survival Curve Rectangularization in Korea, (1970-2010)

BACKGROUND: The future health of our increasing senior population depends upon the interrelationship between the onset time of the first major disease, infirmity or disability and the time of death. Reduction of morbidity requires compressing the average period between two points and reducing the average level of morbidity during this period. In this article, authors demonstrated the change of mortality curve and estimated the mortality curve upto 2010. And we intend to use this result as basic data in the future for preventive health service, health promotion, and health policy for senior people. METHODS: In this study, the authors demonstrated the survival curve from 1970 to 1995. And we intended to estimate death rate according to age and year upto 2010 and construct a new forecasting model. By using this model, we can calculate the data upto 2010 and suggest mortality curve. RESULTS: According to the results, the relative and absolute rectangularization and the convergency of survival curves were observed, and all the Keyfitz's H, NH, SD and CV decreased while the life expectancy in creased in the period of 1970 to 2010. So we conclude that the hypothesis of mortality compression suggested by Fries explains the changing pattern of aged population in Korea very well. CONCLUSION: According to Fries theory, this study shows compression of mortality is exist in Korea But when we observe the tail of mortality curve, there are no evidence that life expectancy reaches to limitation in Korea and we expect life expectancy of Korean will continuously increase.

Relation between Cognitive Impairment and Activity of Daily Living in the Elderly of Nursing Home and Community

BACKGROUND: Due to the increase in average life expectancy, the number of elderly people in the population has also increased and it is argued that this has led to a rise in chronic regression type diseases or dementia and related psychoneurological diseases, together with the growing occurrence of cognitive function disorders. However, it can be said that research in Korea towards systematic general function assessment or machinery for diagnosis is insufficient. Accordingly, the authors of this paper, investigated elderly people, both institutionalized and shill living in the community for their cognitive functions and their ability to carry out daily life skills. Afterwards, the early diagnosis of mental illness and rehabilitation management for elderly patients was put into operation for this research. METHODS: During October of 1997 a certain retirement home in Kyonggi-do and a public health centre in Seoul were visited and forty patients from the home, and forty-five patients from the health centre, all over 65 years of age, were the objects of tests for cognition functions using the mini-mental status examination -Korea(MMSE-K), Their ability to carry out activity of daily living was tested through the modified Ballhel index for measurement, comparison and analysis. RESULTS: The group from the institution had an average MMSE-K of 24.05 with no significant difference between gender, age and degree of education. The health centre group's MMSE-K of 26.16 was a higher ,score(p<0.05), by men and by at least elementary ,school education. If we look at different classifications, the institutionalized group included 13 people(32.5%) ar a normal level, 18 people (45.0%) with mildly impairments, 9 people(17.5%) had moderately impairments and no severly handicapped patients. Looking at the community elderly, 23 people(51.1%) were at a normal level, 19 people (42.2%) had middle impairments, 3 people(6.7%) had moderately impairments and there were no severly impairments. With the MBI, the institutionalized group had an average of 95.9 and the community group had an average of 98.62 so both ,scored highly(p<0.05). If the MBI of the two group's dependency is compared, 17 people(42.5%) of the institution's elderly were independent in activity of daily living, 17 people(42.5%) were minimal dependent and the remaining 6 people(15.%) were mild dependent. 30(66.7%) of the community elderly were independent in daily living activity, 14 people (31.1%) were mild dependent and 1 people(2.2%) war mild dependent. Even the elderly with normal cognitive functions had disorders with their daily living activity Therefore a sample of the patients have above average damaged cognitive functions and severe living activity disorders are being seen in both groups. CONCLUSION: Both the community and institutionalized elderly had resonable cognition and the institutionalized groups had especially high levels. It is now believed that there is a relation between this and the lack of suitable evaluation in Korea. Even if the daily living activity disorders were not severe, they were observed in both groups, so henceforth, if cognitive function tests were made with consideration given to age and gender, and activity of daily living tests were implemented efficiently, the overall health and well-being of the elderly, and therefore demands for medical treatment and social services, could be decided and put into operation.