Abdominal obesity, systolic blood pressure, and microalbuminuria in normotensive and euglycemic Korean men.

OBJECTIVES: To evaluate the relationship between abdominal obesity and microalbuminuria (MA) in normotensive, euglycemic Korean men. DESIGN: A cross-sectional study at a health screening center. SUBJECTS: A total of 1321 healthy, normotensive Korean men, aged 20-78 years, with a fasting plasma glucose level <100 mg/dl. MEASUREMENTS: Height, weight, and waist; systolic blood pressure (SBP); diastolic blood pressures (DBP); urinary albumin to creatinine ratio (ACR); fasting glucose, insulin, lipids, C-reactive protein (CRP), and white blood cell count. Waist circumference (WC) was used to indicate abdominal obesity and a single measurement of ACR was used to estimate MA. We also calculated body mass index (BMI) based on weight and height. RESULTS: Mean BMI, WC, and SBP were significantly higher in subjects with MA than in those without (24.8+/-4.1 vs 23.8+/-2.7 kg/m2, 86+/-9 vs 83+/-8 cm, and 115+/-5 vs 112+/-7 mmHg, respectively). Multiple logistic regression analyses showed that only WC and SBP were independent predictors of MA. CONCLUSION: WC and SBP were positively associated with MA in normotensive and euglycemic Korean men.

Predictors of prescription of morphine for severe cancer pain by physicians in Korea.

BACKGROUND: This study was undertaken to identify predictors of the prescription of strong opioids, which are important for the management of severe cancer pain, by Korean physicians. METHODS: A questionnaire based on a hypothetical case designed to assess the prescription of morphine by physicians was administered to 800 specialists in the Korea Cancer Association, of whom 147 (18.4%) responded, and to 2200 specialists in the Korean Academy of Family Medicine, of whom 388 (17.6%) responded. We used a multidimensional approach to identify the predictors of prescription of morphine by physicians. RESULTS: In the hypothetical case scenario, only 16.5% of the respondents stated that they would prescribe morphine for severe cancer pain. Multiple logistic regression analysis showed that physicians with a positive attitude regarding opioid addiction [odds ratio (OR) 2.62; 95% confidence interval (CI) 1.54-4.46], experience of pain assessment (OR 2.09; 95% CI 1.13-3.87), recent residency training (OR 2.27; 95% CI 1.30-4.0) and positive self-evaluation as an oncology specialist (OR 2.60; 95% CI 1.41-4.78) were more likely to prescribe morphine. None of the 13 variables in the knowledge dimension significantly predicted prescription of morphine for severe cancer pain. CONCLUSIONS: The results of the survey suggest that we need to develop strategies to develop a positive attitude toward opioids, to increase experience in pain assessment and to improve cancer pain management training among Korean physicians.

Home telecare system integrated with periodic health reminder and medical record & multimedia health information.

The necessity of home telecare system is growing due to increase in desire for health promotion owing to increase in chronic diseases, aged population and medical expenses. Already, we computerized patient's data and offer periodic health reminder to patients for health promotion by using Life-time Health Monitoring Program (LHMP). Our study connected LHMP to the Web on internet by CGI as an electronic medical record; enabling reference to patient's medical records anywhere. The study also made possible video teleconsultation and constructed multimedia database to provide health-related information to the patients. On these bases, a flow chart was developed using the home telecare to practice manage patients with chronic diseases, old patients, and the handicapped. Further standardization in data, establishment of law bases for home telecare system, development of rules for medical fees and active utilization of biomedical telemetry will be needed to extend home telecare system.

Standardization of the nationwide health examination in Korea.

The Korea Medical Insurance Corporation has held the periodic Health Examination for the public servants and teachers from 1977 as a nationwide health preventive task. But the Health Examination result is not computerized rather than paperwork, so the use of the Health Examination is limited and the results of Health Examination can not be stored or interchangeable between hospitals or health examination centers in this system. So we planed the Standardization of the Nationwide Health Examination project and developed the Health Examination computer program in 1996. The object of standardized program is to contribute to cost-effective analysis of each item or other studies about the factors influences development of diseases. And now, an Exhibition work for the standardization is being held with the Health Examination computer program. At the ending of the Exhibition work, we will evaluation and revision the computerized program for standardization process.

Information system for a periodic examination and health promotion center.

The periodic examination and health promotion center (PEHPC) in Seoul National University Hospital has developed and adopted an information system supported by computers which use an electronic medical record to improve the quality of patient care, advance the science of medicine, lower health care costs, and enhance the education of health care professionals. This information system adopted the concept of incomplete and evolutionary systems to conduct the pursuit of practicalness and efficacy. It has increased efficiency to save costs and to enhance the quality of the medical service. It has also activated clinical research due to ease of managing data. We are also preparing for telecare. Telecare and WWW-using information system is postponed because the protection of a patients privacy is not established.