RÉSUMÉ
Background@#White matter hyperintensity (WMH) is a risk factor for dementia and ischemic stroke. The atherogenic index of plasma (AIP) is a simple and cost-effective marker for the prediction of various vascular diseases. In this study, we evaluated the relationship between AIP and WMH in adults without cerebrovascular accidents. @*Methods@#We analyzed the data of 281 adults, aged ≥26 years, who underwent brain magnetic resonance imaging (MRI) at the health promotion center of an education hospital between January 2014 and December 2018. Participants were divided into three categories according to tertiles of the AIP scores (T1: 0.48). WMH was defined as a modified Fazekas scale score of 1–3 on brain MRI. A cubic spline curve was used to determine the linearity of the relationship between AIP and WMH. Multiple logistic regression analysis was used to evaluate the relationship between the AIP and WMH. @*Results@#The prevalence of WMH was 45.7% in T1, 57.0% in T2, and 66.0% in T3 (T3 vs. T1, P for post-hoc analysis=0.005). The increased odds of WMH were associated with increased AIP. The odds ratio (OR) with a 95% confidence interval (CI) for WMH of T2 and T3 compared with T1 were 1.57 (0.88–2.80) and 2.30 (1.28–4.14), respectively. After adjusting for confounding variables, the OR with a 95% CI for WMH in the T2 and T3 groups vs. the referent T1 were 1.55 (0.76–3.13) and 2.27 (1.06–4.84), respectively. @*Conclusion@#AIP is independently and positively associated with WMH in a healthy population.
RÉSUMÉ
BACKGROUND: The aortic knob width (AKW) and the heart rate variability (HRV) were suggested to be related to development of cardiovascular diseases. However, the relationship between them has not been investigated; thus, this study aimed to determine this relationship. METHODS: This study included 587 Koreans aged 18–79 years. Their physical measurements, medical and social histories, blood test findings, and chest radiographs were obtained. The HRV parameters included the standard deviation of the N-N interval (SDNN), root mean square of successive differences (RMSSD), approximate entropy (ApEn), total power (TP), very low frequency (VLF), low frequency (LF), high frequency (HF), and LF/HF ratio, which were measured for 5 minutes. The AKW was measured on chest radiographs by a single reviewer. RESULTS: The AKW was significantly correlated with the HRV parameters, except for the LF/HF ratio. However, RMSSD and ApEn were not significantly related to the AKW in women. After dividing the participants into quartile groups, the AKW was significantly related to the SDNN, RMSSD, TP, VLF, LF, and HF. The HRV parameter values decreased in the higher AKW quartile groups, the HRV parameter values decreased. After adjusting for sex, drinking status, exercise habits, smoking status, waist circumference, and triglyceride, low-density lipoprotein cholesterol, fasting blood sugar, and glycated hemoglobin levels, the AKW showed significant negative associations with the HRV parameters, except for the LF/HF ratio. CONCLUSION: The AKW is significantly associated with the HRV parameters of SDNN, RMSSD, ApEn, TP, VLF, LF, and HF.
Sujet(s)
Femelle , Humains , Aorte thoracique , Glycémie , Maladies cardiovasculaires , Cholestérol , Consommation de boisson , Entropie , Jeûne , Rythme cardiaque , Coeur , Tests hématologiques , Hémoglobine glyquée , Lipoprotéines , Radiographie thoracique , Fumée , Fumer , Triglycéride , Tour de tailleRÉSUMÉ
BACKGROUND: Both aortic knob width and metabolic syndrome are suggested to be related to atherosclerosis and cardiovascular diseases. However, the association between aortic knob width and metabolic syndrome is unknown. This study aimed to explore this relationship. METHODS: Participants were 3,705 Korean adults aged 18–79 years who visited the health promotion center of a general hospital. Data on chest radiography, physical measurements, medical and social history, and blood tests were collected. We defined metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria. A single reviewer measured aortic knob width on chest radiography. RESULTS: Aortic knob width was significantly correlated with age; body mass index; waist circumference; systolic and diastolic blood pressures; total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting glucose, glycated hemoglobin, insulin, and uric acid levels; and homeostatic model assessment of insulin resistance values. Aortic knob width significantly increased as the number of metabolic syndrome components increased. Moreover, metabolic syndrome component values tended to increase across the quartile groups of aortic knob width after adjusting for age, exercise, smoking status, and alcohol use. Through receiver operating characteristic curve analysis, we determined the clinically useful cutoff value for aortic knob width to be 30.47 mm in premenopausal women. CONCLUSION: Aortic knob width was found to be significantly related to metabolic syndrome and its individual components.
Sujet(s)
Adulte , Femelle , Humains , Aorte thoracique , Athérosclérose , Indice de masse corporelle , Maladies cardiovasculaires , Cholestérol , Éducation , Jeûne , Glucose , Promotion de la santé , Tests hématologiques , Hémoglobine glyquée , Hôpitaux généraux , Insuline , Insulinorésistance , Lipoprotéines , Radiographie , Courbe ROC , Fumée , Fumer , Thorax , Triglycéride , Acide urique , Tour de tailleRÉSUMÉ
BACKGROUND: The aim of this study was to determine the association between carotid intima-media thickness (IMT) and newly developed 10-year atherosclerotic cardiovascular disease (ASCVD) risk score. METHODS: Participants were 201 Korean adults who underwent carotid ultrasonography at the Health Promotion Center of the Eulji General Hospital. We obtained information about medical history and lifestyle, and conducted laboratory tests. Carotid IMT by B-mode ultrasonography was measured. Carotid injury was considered present when the maximum carotid IMT was > or =0.9 mm or when arteriosclerotic plaques were detected. The 10-year ASCVD risk score was calculated using the 2013 American College of Cardiology/American Heart Association guidelines. RESULTS: Men had higher 10-year ASCVD risk score than did women (mean+/-standard deviation: 7.15+/-6.04 vs. 2.53+/-3.67, respectively; P<0.001). Ten-year ASCVD risk was significantly correlated with right maximum carotid IMT (r=0.307), left maximum carotid IMT (r=0.230), right mean carotid IMT (r=0.322), and left mean carotid IMT (r=0.264). The group with high 10-year ASCVD risk were at even higher risk of carotid injury than were the group with low 10-year ASCVD risk (odds ratio, 2.201; 95% confidence interval, 1.162-4.1706; P=0.019). Only 10-year ASCVD risk score was significantly associated with carotid injury (odds ratio, 4.104; 95% confidence interval, 1.570-10.729). Variables that were not included in the 10-year ASCVD risk score were not significantly associated with carotid injury. CONCLUSION: The findings of this study suggest that 10-year ASCVD risk score is associated with carotid injury.
Sujet(s)
Adulte , Femelle , Humains , Mâle , Athérosclérose , Maladies cardiovasculaires , Épaisseur intima-média carotidienne , Sténose carotidienne , Promotion de la santé , Coeur , Hôpitaux généraux , Mode de vie , ÉchographieRÉSUMÉ
BACKGROUND: Cervical intraepithelial neoplasia (CIN) grading is subjective and affected by substantial rates of discordance among pathologists. Although the use of p16INK4a (p16) staining has been proven to improve diagnostic accuracy for high-grade squamous intraepithelial lesion (HSIL), the clinical evidence for use of Ki-67 and proliferating cell nuclear antigen (PCNA) is insufficient to make an independent recommendation for use, alone or in combination. The primary objective was to evaluate clinical utility of Ki-67 and PCNA in combination with p16 in diagnosing HSIL. Also, we assessed the correlation between expressions of three biomarkers and resection margin status of conization specimen. METHODS: The expressions of p16, Ki-67, and PCNA were evaluated by immunohistochemical methods in 149 cervical tissues encompassing 17 negative lesion, 31 CIN 1, 25 CIN 2, 41 CIN 3, and 35 invasive squamous cell carcinoma. The immunohistochemical staining results were classified into four grades: 0, 1+, 2+ and 3+. RESULTS: The expression of three biomarkers was positively associated with CIN grade. Ki-67 immunostaining did not increase the accuracy of HSIL diagnosis when combined with p16 immunostaining compared with p16 immunostaining alone. In contrast, combining the staining results for p16 and PCNA (p16 = 3+ and PCNA > or =2+) increased its specificity (66.7% vs. 75.0%, P = 0.031) without decrease of its sensitivity (98.7% vs. 98.7%) for diagnosis of CIN 3 and more sever lesion. Subgroup analysis for conization specimen with CIN 2 and CIN 3 showed that positive Ki-67 immunostaining was an independent risk factor for predicting resection margin positivity (odds ratio = 6.52, 95% confidence interval 1.07-39.64). CONCLUSIONS: We found that the combined use of p16 and PCNA immunostaining enhanced diagnostic accuracy for HSIL. Positive Ki-67 immunostaining was associated with incomplete excision.
Sujet(s)
Marqueurs biologiques , Carcinome épidermoïde , Dysplasie du col utérin , Conisation , Diagnostic , Antigène nucléaire de prolifération cellulaire , Facteurs de risque , Sensibilité et spécificitéRÉSUMÉ
BACKGROUND/AIMS: The relationship between Crohn's disease and gallstones is established. However, the prevalence and risk factors for gallstones in patients with ulcerative colitis (UC) are not yet well understood. The aim of this study was to evaluate the prevalence and risk factors of gallstones in patients with UC. METHODS: This study was a retrospective single center study. A total of 87 patients with UC and 261 healthy controls were enrolled. Age, sex, and body mass index were matched. To investigate risk factors, the extent of UC, duration of disease, number of hospital admissions, and number of steroid treatments in patients with UC were evaluated. RESULTS: The prevalence of gallstones in patients with UC was 13.8%, whereas that in healthy controls was only 3.1% (P or =50 years of age had a 3.6-times higher risk of gallstones compared to that in those <50 years of age, and the difference was statistically significant (odds ratio, 3.60; confidence interval, 1.03-12.61) in univariate analysis. There were no statistically significant disease-related risk factors for gallstones in UC patients. CONCLUSIONS: This is the first study of gallstone prevalence in Korean UC patients. In this study, patients with UC had a higher prevalence of gallstones compared to that in well-matched healthy controls. Age seemed to be a possible risk factor, and more studies are needed. Further prospective, large-scale studies will be required to confirm the risk factors for gallstones in UC patients.
Sujet(s)
Humains , Maladies asymptomatiques , Indice de masse corporelle , Rectocolite hémorragique , Maladie de Crohn , Calculs biliaires , Prévalence , Études rétrospectives , Facteurs de risqueRÉSUMÉ
BACKGROUND/AIMS: The relationship between Crohn's disease and gallstones is established. However, the prevalence and risk factors for gallstones in patients with ulcerative colitis (UC) are not yet well understood. The aim of this study was to evaluate the prevalence and risk factors of gallstones in patients with UC. METHODS: This study was a retrospective single center study. A total of 87 patients with UC and 261 healthy controls were enrolled. Age, sex, and body mass index were matched. To investigate risk factors, the extent of UC, duration of disease, number of hospital admissions, and number of steroid treatments in patients with UC were evaluated. RESULTS: The prevalence of gallstones in patients with UC was 13.8%, whereas that in healthy controls was only 3.1% (P or =50 years of age had a 3.6-times higher risk of gallstones compared to that in those <50 years of age, and the difference was statistically significant (odds ratio, 3.60; confidence interval, 1.03-12.61) in univariate analysis. There were no statistically significant disease-related risk factors for gallstones in UC patients. CONCLUSIONS: This is the first study of gallstone prevalence in Korean UC patients. In this study, patients with UC had a higher prevalence of gallstones compared to that in well-matched healthy controls. Age seemed to be a possible risk factor, and more studies are needed. Further prospective, large-scale studies will be required to confirm the risk factors for gallstones in UC patients.
Sujet(s)
Humains , Maladies asymptomatiques , Indice de masse corporelle , Rectocolite hémorragique , Maladie de Crohn , Calculs biliaires , Prévalence , Études rétrospectives , Facteurs de risqueRÉSUMÉ
BACKGROUND: Different regional fat depots have different effects on lipid and glucose metabolism. The purpose of this study is to examine the relationship between body fat distribution as measured by dual-energy X-ray absorptiometry (DEXA) and metabolic risk factors and to disclose whether there is any difference between groups with and without metabolic syndrome (MS). METHODS: A total of 292 participants (98 men, 194 women) over 19 years old underwent whole-body DEXA to evaluate body composition with respect to the whole body, leg, arm, and android regions. Anthropometry and blood tests for metabolic risks were measured. RESULTS: One hundred and seven participants were diagnosed with MS. The MS group had significantly higher android fat (%) and had lower leg fat (%), arm fat (%), and appendicular (arms + legs) fat (%) than the non-MS group. Android fat (%) had a positive correlation with waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, log insulin, hemoglobin A1c (HbA1c), triglyceride (TG), and low density lipoprotein cholesterol, and had a negative correlation with high density lipoprotein (HDL) cholesterol. Appendicular fat (%) had a negative correlation with WC, SBP, DBP, glucose, log insulin, HbA1c, and TG, and had a positive correlation with HDL cholesterol. The association of appendicular fat with metabolic risk was consistently observed in non-MS, but the association was not observed except for SBP, glucose and log insulin in MS. CONCLUSION: In contrast with the adverse effects of android fat, appendicular fat distribution was associated with decreased risks of MS. The protective effect of appendicular fat against metabolic risk factors in non-MS was less characteristic in MS.
Sujet(s)
Humains , Mâle , Absorptiométrie photonique , Anthropométrie , Bras , Pression sanguine , Composition corporelle , Répartition du tissu adipeux , Cholestérol , Cholestérol HDL , Cholestérol LDL , Glucose , Tests hématologiques , Insuline , Jambe , Lipoprotéines , Métabolisme , Facteurs de risque , Triglycéride , Tour de tailleRÉSUMÉ
OBJECTIVE: To evaluate one-year outcomes of tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence (SUI). METHODS: From 2002 to 2005, all patients with stress urinary incontinence undergoing the TVT procedure were enrolled in this retrospective study. All cases were diagnosed as SUI by the evidences in history, physical examination, and urodynamic study. Outcomes and post-operative complications were investigated from review of medical records and interview during post-operative follow-up. RESULTS: Totally 164 cases were enrolled in this study. The success rates (cure or improved) of two-month and one-year after the TVT procedure were 94.5% and 87.9%, and the failure rates were 5.5% and 3.0%, respectively. The follow-up loss rate in one-year was 9.1%. There was no serious complication related to the procedure in one-year follow-up. CONCLUSION: This preliminary report indicates that the TVT procedure is a safe treatment modality for female SUI. Further investigation with long term follow-up is required to estimate cumulative success rate and late complications.
Sujet(s)
Femelle , Humains , Études de suivi , Dossiers médicaux , Examen physique , Études rétrospectives , Bandelettes sous-urétrales , Incontinence urinaire , UrodynamiqueRÉSUMÉ
OBJECTIVE: To evaluate the pregnancy outcomes of women with congenital uterine anomaly exceeding 20 weeks of gestation. METHODS: We reviewed retrospectively the birth records of the Seoul National University Hospital between January 1, 1990, and December 31, 2005. We grouped congenital uterine anomalies into five classes, namely bicornuate, didelphys, septate, arcuate, and unicornuate uterus. We compared the pregnancy outcomes with each anomaly. RESULTS: We found 106 cases of congenital uterine anomaly within a given period of time. There were 63 cases of bicornuate uterus, 19 cases of didelphys, 16 cases of septate uterus, 5 cases of arcuate uterus, and 3 cases of unicornuate uterus. The overall preterm delivery rate was 22.6% (24/106) and cesarean section rate was 74.5% (79/106). A high cesarean section rate was due to metroplasty, abnormal fetal presentation, and uterine anomaly itself. The preterm delivery rate and cesarean section rate of each uterine anomaly did not differ statistically from one another. Five fetuses were stillborn, and one fetus died after birth because of a placenta abruption. The overall take-home baby rate was 94.3% (100/106). There was no maternal mortality and only one case was suffered from postpartum bleeding. CONCLUSION: Our results suggest that the most of women with uterine anomaly exceeding 20 weeks of gestation may take their baby home.
Sujet(s)
Femelle , Humains , Grossesse , Grossesse , Certificats de naissance , Césarienne , Foetus , Hémorragie , Présentation foetale , Mortalité maternelle , Travail obstétrical prématuré , Parturition , Placenta , Période du postpartum , Issue de la grossesse , Études rétrospectives , Séoul , UtérusRÉSUMÉ
BACKGROUND: To investigate the relationship between adiposity and risk factors for cardiovascular disease (CVD) in normal weight individuals. METHODS: The study subjects were those over 19 years old, less than 23 kg/m2 of body mass index (BMI). They were examined in a health promotion center of a general hospital from June to November, 2001 (309 men and 369 women). Height, weight, BMI, blood pressure (BP), serum lipids and fasting blood glucose (FBS) were checked. Percent body percent (%BF) was obtained by bioelectrical method. Normal weight subjects were divided into two groups according to their %BF; then, the groups were evaluated for the presence of CVD risk factors. RESULTS: The average age of the study subjects was 43.66+/-11.26 years old in men and 41.11+/-10.90 years old in women. The average BMI was 21.15+/-1.47 kg/m2 in men and 20.68+/-1.53 kg/m2 in women. High %BF group showed significantly increased frequency of higher BP, FBS, total cholesterol (TC), triglyceride (TG) and LDL-cholesterol (LDL-C) compared with low %BF group in both sexes. In men, odds ratios (ORs) of the high %BF group with respect to the low %BF group were significantly high for BP and TG elevation. ORs of the high %BF group were significantly high for FBS, TC, LDL-C and TG elevation in women. ORs for more than one CVD risk factor was 2.46 (1.38~4.38) in men and 1.50 (0.95~2.36) in women. CONCLUSION: Increased %BF was related to cardiovascular risk factors in normal weight subjects. The result was more significant for normal weight men than normal weight women.
Sujet(s)
Adulte , Femelle , Humains , Mâle , Tissu adipeux , Adiposité , Glycémie , Pression sanguine , Indice de masse corporelle , Maladies cardiovasculaires , Cholestérol , Jeûne , Promotion de la santé , Hôpitaux généraux , Odds ratio , Facteurs de risque , TriglycérideRÉSUMÉ
BACKGROUND: As the metabolic syndrome represents a constellation of cardiovascular risk factors,its prevention is very important. Especially, child and adolescent obesity and metabolic abnormalities track into adulthood and it may promote the development of the metabolic syndrome in adults. however, in Korea there are only few studies about the metabolic syndrome of children and adolescents. Therefore, the objective of this study was to determine the prevalence and distribution of the metabolic syndrome in Korean children and adolescents. METHODS: The Korean National Health and Nutrition Survey (KNHNS) 2001 was a nation representative survey with a stratified multistage sampling design. Data from a comprehensive questionnaire, physical examination, and blood sample were obtained from 1,090 Korean children and adolescents (567 boys, 523 girls), aged 10 to 19 years. The metabolic syndrome was determined by using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) definition modified for age. RESULTS: The prevalence of the metabolic syndrome in Korean children and adolescents was 7.1% (9.2% in boys, 4.8% in girls). The syndrome was present in 36.6% of overweight children and adolescents (body mass index [BMI] > or = 95th percentile) compared with 11.2% of at-risk children and adolescents (BMI 85th to <95th percentile) and 2.5% of those with a BMI below the 85th percentile (P<0.001). A multivariate logistic regression model showed a significant increase in risk of the metabolic syndrome in association with gender and BMI. CONCLUSION: Overall, 7.1% of children and adolescents and 36.6% of overweight children and adolescents in Korea met the criteria for the metabolic syndrome. These findings emphasize the need for both public health and clinical interventions to improve the detection, prevention, and treatment of the metabolic syndrome, especially in obese children and adolescents.
Sujet(s)
Adolescent , Adulte , Enfant , Humains , Maladies cardiovasculaires , Cholestérol , Éducation , Corée , Modèles logistiques , Enquêtes nutritionnelles , Obésité , Surpoids , Obésité pédiatrique , Examen physique , Prévalence , Santé publique , Enquêtes et questionnairesRÉSUMÉ
BACKGROUD: Body weight is a well known factor of bone density. However, studies for correlation between body fat, lean body mass and bone density are inconsistent in premenopausal women. We reviewed the relations of body weight, body mass index (BMI) , body fat, body fat percent, fat free mass and spinal bone density. METHODS: We collected data of healthy young women of 20-39 years old who visited a health promotion center of a general hospital from March to August, 2000, and examined the correlation of body weight, BMI, body fat, body fat percent, fat free mass and spinal bone density. RESULTS: The total number of observation was 309, the average age was 34+/-4 year old, the average body weight was 55.4+/- 7.7kg, the height was 158+/-5 cm, the BMI was 22.05+/-2.80 kg/m2, the body fat percent was 25.5+/-5.3%, and the spinal bone density was 1.007+/-0.1106g/cm2,. The incidence of normal bone density, osteopenia, osteoporosis of spine was 45.5%, 54.5%, 0%,respectively,in the low body weight group,72.6%,26.8%,0.5%, respectively, in the normal weight group, and 90.9%,9.1%,0%, respectively, in the obese group. In linear regression analysis, the spinal bone density correlated with age, height,weight, BMI, body fat, and fat free mass. In stepwise multiful regression analysis, the fat free mass was a significant factor (R2 =0.065(P<0.001) ) of the spinal bone density. CONCLUSIONS: The spinal bone density was correlated with age, height, body weight, BMI, fat mass, and fat free mass. The multiple regression analysis suggested that only fat free mass was significantly correlated with spinal bone density.
Sujet(s)
Femelle , Humains , Tissu adipeux , Composition corporelle , Taille , Indice de masse corporelle , Poids , Densité osseuse , Maladies osseuses métaboliques , Promotion de la santé , Hôpitaux généraux , Incidence , Modèles linéaires , Ostéoporose , RachisRÉSUMÉ
BACKGROUND: C-reactive protein is an acute phase reactant, which can be increased by either (both) infectious or (and) non-infectious and non-specific reaction of cells and tissue metabolism. Also C-reactive protein is known to have a relationship between changes in lipid and glucose metabolism. In recent studies, the possibility of being a prognostic factor of cardiovascular risk factors and serum C-reactive protein concentration within conventional reference ranges in otherwise normal people has also received little attention. Therefore, in this study, we tried to look for the relationship between C-reactive protein and cardiovascular risk factors of a healthy adult. METHODS: We analyzed the results of the surveys and chemistries given to 3,548 healthy men and women who have visited the heath promotion center in a certain university hospital. We assayed the C-reactive protein by means of rate nephelometry. We omitted the case of 123 people who went over 1mg/dL. We compared C-reactive protein of normal and abnormal range of each risk factor and went through the multiple regression analysis for the factors with significant differences. RESULTS: When C-reactive protein concentration of normal and abnormal of cardiovascular risk factors were compared by t-test, there were differences according to age (p<0.001), sex (p<0.001), body mass index (p<0.001), WBC (p<0.001), systolic blood pressure (p<0.001), diastolic pressure (p<0.001), total cholesterol (p<0.00), HDL-cholesterol (p<0.05) and smoking (p<0.01). We could not find any significant difference of triglycerides. After going through multiple regression analysis for the risk factors, which showed a significant difference by t-test, we found out that the C-reactive protein increased as cholesterol (p<0.01), body mass index (p<0.01) and WBC (p<0.001) increased. As for HDL-cholesterol (p<0.001), the C-reactive protein increased as it decreased. Age, sex, smoking history, systolic blood pressure, and diastolic blood pressure did not show significant relationship we were looking for. CONCLUSION: C-reactive protein was not related to age, smoking history ,blood pressure, and triglycerides among cardiovascular risk factors, but was related to body mass index, cholesterol, HDL-cholesterol and WBC. This relationship indicated that even if the C-reactive protein was in normal range a person with C-reactive protein should be aware of the risk involved for cardiovascular diseases.
Sujet(s)
Adulte , Femelle , Humains , Mâle , Pression sanguine , Indice de masse corporelle , Protéine C-réactive , Maladies cardiovasculaires , Cholestérol , Glucose , Métabolisme , Néphélométrie et turbidimétrie , Valeurs de référence , Facteurs de risque , Fumée , Fumer , TriglycérideRÉSUMÉ
BACKGROUND: There has been no systematic investigation of the necessary core procedures in primary care in Korea. The purpose of this study is to examine the core procedures necessary in primary care and to have the results reflected in residency programs. METHODS: A mail survey was conducted fram May 2, to August 20, 1997 among 478 physicians who qualified as a family physician specialist since 1989. The contents of the questionnaire included 1) sex, age, locatian and size of the hospital 2) of the 93 procedures that should be taught during residency pragrams as suggested by the [American Academy of Family Physicians] and the [Korean Academy of Family Physicians a) procedures taught in residency programs, b) procedures performed by practicing family physicians, and, c) procedures considered as necessary in primary care. RESULTS: 1) Of the 93 procedures, 78 were taught in residency programs, 35 were performed by practicing family physicians, and 77 were considered necessary in primary care. 2) All of the 35 procedures performed by family physicians were taught in the residency programs. Of the 77 procedures considered necessary in primary care, 71 were taught but the remaining 6 were infrequently taught. 3) 7 procedures were taught but was considered unnecessary ; Procedures taught but not actually performed amounted to a total of 43. 4) 42 procedures were considered necessary but not performed. 5) More procedures were performed by male doctors(p<0.05). Surgical procedures were performed more often in regional hospitals than those in Seoul and in the larger cities(p<0.05), and more were performed in private practice(p<0.05). CONCLUSIONS: Although almost all of the procedures considered necessary in primary care were taught in residency programs, many procedure's were not being performed in current medical practice. We suggest that it would be more effective to intensively train the core procedures than to provide exposure to a wide array of procedures. As the procedures performed were found to vary in relat
Sujet(s)
Humains , Mâle , Internat et résidence , Corée , Médecins de famille , Service postal , Soins de santé primaires , Séoul , Spécialisation , Enquêtes et questionnairesRÉSUMÉ
BACKGROUND: HBsAg carriers are 6-12% of population in Korea. The patients knowledge on hepatitis B and regular follow-up tests are important, because HBsAg carriers have infectivity and the disease may progress without symptoms. We surveyed their knowledge on the hepatitis B and the frequency of follow-up blood test and sonogram. METHODS: From March 1993 through September 1994, 630 patients who were diagnosed as HBsAg positive and Anti-HBs negative in a health promotion center of college hospital were surveyed by mailing questionnaire. The questionnaire included the result of HBV viral marker test, transmission routes, complications, and prevention methods of Hepatitis B, frequency of follow-up test, and doctors recommendation. RESULTS: Of the 490 questionnaires excluded the 140 questionaires returned due to wrong address, 100 were answered, making the reply rate 20.4%. As for the result of HBV marker test, 64% answered their HBV marker as HBsAg positve, 10% answered HBsAg negative, and 26% answered I dont know. 65% answered that they are HBV carrier. As for the mode of transmission, 59% answered that HBV is transmitted by blood, 57% from carrier mother at birth, 29 % by sexual intercourse. 76% of responders know that vaccination is needed for preventing vertical transmission. When making score on their knowledge, significant differences were showed according to education, income and doctors recommendation about regular follow-up test. The number of persons who took regular blood test every 6 to 12 months were 56(56%), and the number of persons who took regular abdominal ultrasonogram were 39(39%). The number of patients who were recommended regular follow-up by doctor was 76%. In this group, 51 persons(67.0%) took regular blood test and 35 persons(35%) took regular sonogram so this frequency is significantly higher than the other group(each 20.8%, 16.7%). CONCLUSIONS: The knowledge on hepatitis B in HBsAg positive patients is relatively low and the frequency of regular follow-up test is significantly higher in the group who took doctors recommendation. So it is very important that HBsAg carriers must be educated about the infectivity, preventive methods, and regular follow-up for early detection of complication like hepatocellular cancer.