Tetanus is a neurologic disease which features the muscle spasm as the hallmark. It is an infectious disease with high mortality rate triggered by tetanospasmin produced by Clostridium tetani. This report concerns incidence of tetanus consequent to oriental medical care such as acupuncture and moxibustion. Although the tetanus occurrence has shown a remarkable decline since nationwide vaccinations in some of the developed countries, including Korea, it still remains to be an important issue, to be dealt within Korea, as the majority of the patients are old aged and Korean population is rapidly becoming an aging society. Furthermore, since more elders are coming to rely on Oriental medicine in Korea, the Korean elders are at a higher risk than elsewhere. The lack of medical experiences, including those in oriental medical field, has been hindering early diagnosis of Tetanus. This study aims to encourage rapid and accurate decisions in diagnosis and treatment through reviewing symptoms particularly specific to tetanus, and also to arouse attention to the riskiness of invasive procedures involving skin puncture.
Acupuncture ; Aged ; Aging ; Clostridium tetani ; Communicable Diseases ; Developed Countries ; Early Diagnosis ; Humans ; Incidence ; Korea ; Medicine, East Asian Traditional ; Metalloendopeptidases ; Moxibustion ; Punctures ; Skin ; Spasm ; Tetanus ; Tetanus Toxin ; Vaccination

BACKGROUND: To investigate the association between childhood obesity and its risk factors according to specific childhood developmental stages. METHODS: We performed an analysis of data for 1922 children and adolescents aged 2 to 18 years obtained from the Third Korea National Health and Nutrition Examination Survey conducted in 2005. Weight and height were measured by trained interviewers. Childhood obesity was defined as BMI > or =95th percentile of the BMI cut-off point based on the Korean child growth curve. Data on socioeconomic characteristics such as age, education, occupation, income, physical activity and time spent watching television were collected using a well-established questionnaire and/or interview. RESULTS: The prevalence of obesity defined by using the Korean child growth curve was 4.1% in children aged 2 to 6, 6.3% in children aged 7 to 12, and 8.7% in adolescents aged 13 to 18. In the multiple logistic regression model, parental obesity, and time spent watching television were associated with increased risk of obesity in children aged 2~6. Parental obesity, family income level, birth weight, and time spent watching television were positively associated with obesity in children aged 7~12. In adolescents aged 13~18, participation in vigorous physical activity and attempts to control weight were associated with adolescent obesity. CONCLUSION: The prevalence and risk factors of childhood obesity vary substantially according to developmental stage. Differential approaches are needed for effective control of childhood obesity.
Adolescent ; Aged ; Birth Weight ; Child ; Humans ; Korea ; Logistic Models ; Motor Activity ; Nutrition Surveys ; Obesity ; Occupations ; Parents ; Prevalence ; Risk Factors ; Television ; Surveys and Questionnaires

BACKGROUND: Complementary and alternative medicine (CAM) use is popular and current trend suggests a demand for CAM education during residency training. Our objective was to assess perception, the need and experience of CAM education for family practice residents by training faculty. METHODS: A questionnaire was administered to family physicians (n=262) who were registered in the Korean Academy of Family Medicine as residency training faculty between February and May 2006. RESULTS: One hundred and seven (40.8%) of 262 faculty completed the questionnaires. Eighty three (77.6%) respondents recognized the need of CAM education during residency training and fifty two (46.8%) respondents have already educated some kind of CAM. Thirty nine (36.4%) respondents replied that partial CAM educational contents were given out at conferences. Seventy eight (72.9%) respondents recognized the need for educating residents on the general outlines of CAM along with education on verified CAM. Sixty six (61.7%) respondents replied that the Korean Academy of Family Medicine should host such education. CONCLUSION: Most family practice training faculty recognized the need for providing CAM education for family practice residents during residency training, but about an half of family practice training faculty did not have experiences of CAM education.
Complementary Therapies ; Congresses as Topic ; Surveys and Questionnaires ; Education, Medical ; Family Practice ; Humans ; Internship and Residency ; Physicians, Family ; Republic of Korea

BACKGROUND: Due to rapidly growing elderly population, there are increasing numbers of older persons with multiple chronic disorders and geriatric problems arising from polypharmacy. In this study we tried to find out the state of polypharmacy and inappropriate drug prescription and their related factors in community-dwelling elderly by review of drugs taken by older persons visiting a day health center. METHODS: From April 2007 to July 2007, 80 subjects of 65 year-old or over with chronic illness who visited a elderly-wellness and health care center were randomly sampled. All of them were surveyed by structured questionnaires, medical records review, pill counts about all medications they are taking and experience of adverse drug reactions. And all the prescribed medications were reviewed or their drug prescription's appropriateness for each elderly according to Beers criteria. Data results were evaluated by frequency and correlation analyses. RESULTS: The average counts of drugs taken by elderly with chronic disorders were 7.23, minimum 1 to maximum 27 drugs a day. Patients experienced more adverse effects significantly when more prescribed medications were taken (P=0.005), and patients with lack of information about their drugs had taken increased number of medications (P<0.001). Referred to Beers criteria, inappropriate cases of prescription were observed in 26 persons. Those drugs were NSAIDs including aspirin in 17 subjects (21%), amitrityline in 3 (4%), short-acting benzodiazepines in 3 (4%), long acting benzodiazepines in 2 (3%), and anticholinergic antihistamine in 1 (1%). CONCLUSION: Polypharmacy is very common in community-dwelling elderly with chronic disorders. More medications were related to more adverse drug reactions and lack of information about their drugs related to increased number of drug taking. High proportion of inappropriate drug prescriptions was observed in the elderly, which may have resulted from poor education concerning geriatric care of the medical personnels.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Beer ; Benzodiazepines ; Chronic Disease ; Delivery of Health Care ; Drug Prescriptions ; Drug Toxicity ; Humans ; Medical Records ; Polypharmacy ; Prescriptions ; Surveys and Questionnaires

BACKGROUND: This study used MDS-HC 2.0 (Minimum Data Set-Home Care) to analyze the health and the state of function of the traveling health objects. This study was intended to make use of it with the basic materials for providing them with traveling health service suited for the requirement on the health of the traveling health objects. METHODS: The subjects of this study were 1160 people (over 65 years) living under management control of local Health Center from September 7th to October 3th, 2006. This study was analyzed with inter RAI program & SPSS/WIN 10.0, chi-square -test, t-test, and ANOVA. RESULTS: The result showed that 8.97 CAPs per an elderly person was identified and the subjects over 60% had an injury problem from a fall, health prevention service, vision, IADL, pain, and cognition. The number of CAPs in general was high in higher age and the less educated, and those without a job. But, in subjects that had a life partner and a spouse, the number of CAPs was low. In CAPs by the distinction of sex, CAPs which was much more in man than women in statistics were the improvement of health, the abuse of alcohol and drinking wine, bedsore, and the weak supply system. CAPs which women had much more were the function of the heart and the lungs, pain, the performance of the doctor's advice, health prevention service, and incontinence of urine and insertion of catheter. According to the results comparing CAPs by the level of the ADL, the number of CAPs was shown that the group of ADL 2 was higher than group ADL 1. The matter in which the traveling health service had to be applied in all both ADL1 and ADL2 was injury from a fall, health prevention service, and vision. Conculsion: MDS-HC is applicable to decide the care needs for health and social service supplies. The results can be further applicable for careplan, and referral criteria in continuum of care service over long-term care spectrums.
Activities of Daily Living ; Aged ; Catheters ; Cognition ; Continuity of Patient Care ; Drinking ; Equipment and Supplies ; Female ; Health Services ; Heart ; Humans ; Long-Term Care ; Lung ; Pressure Ulcer ; Referral and Consultation ; Social Work ; Spouses ; Vision, Ocular ; Wine

BACKGROUND: More attention is given to oxidative hypothesis which causes atherosclerosis to be recognized as inflammatory response. The relationship between serum ferritin which catalyzes lipid peroxidation and high sensitivity C-reactive protein which reflects vascular inflammation was investigated among adults in a health promotion center. METHODS: The study group consisted of 297 men and women (men 86, women 211) who visited the health promotion center of a hospital in Seoul to have a health checkup from October 1, 2004 to April 1, 2005. These subjects answered the questionnares and were measured in the following; blood tests, brachial-ankle pulse wave velocity and several anthropometric measurements. Statistical analysis was performed on 111 subjects after exclusion of those subjects who were taking antihypertensive agents or antidiabetic agents, and who had acute inflammatory diseases, acute liver diseases, anemia, and who had a WBC > or =11,000x10(3)/mm3 or a serum ferritin > or =200 ug/L or a ABI (Ankle Brachial Index) <0.9. RESULTS: The average serum ferritin concentration of men against women was 132.57+/-43.12 ng/ml to 78.23+/-38.10 ng/ml which means that men have about 1.7 times as high concentration than women (P<0.001). Serum ferritin was significantly correlated with high sensitivity C-reactive protein (r=0.332). Even in multiple stepwise regression analysis, there was a independent relationship between serum ferritin and high sensitivity C-reactive protein (beta=0.138, P=0.010). When we analyzed with distinction of sex, this relationship in women was constant (beta=0.131, P=0.031), but serum ferritin in men just showed the trend of correlation with BMI (beta=9.510, P=0.059). CONCLUSION: There is a significant relationship between the increase of serum ferritin and high sensitivity C-reactive protein in healthy women; furthermore, studies in men need to be confirmed.
Acute Disease ; Adult ; Anemia ; Antihypertensive Agents ; Atherosclerosis ; C-Reactive Protein ; Female ; Ferritins ; Health Promotion ; Hematologic Tests ; Humans ; Hypoglycemic Agents ; Inflammation ; Lipid Peroxidation ; Liver Diseases ; Male ; Oxidative Stress ; Pulse Wave Analysis

No abstract available.
Hepatitis ; Primary Health Care

The prevalence of osteoporosis was increased. Bisphosphonates are effective medications for osteoporosis because these are increasing bone mineral density and lowering the risk of fractures. Recently, bisphosphonate associated osteonecrosis of the jaws has been well documented. Most reports relate to complications resulting from intravenous bisphosphonate therapy. Oral bisphosphonates have a good safety profile in the treatment of osteoprosis. A few cases were reported about oral bisphosphonates associated osteonecrosis, and we could not find Korean case in literatures. The aim of this repot is to present a Korean women case of osteonecrosis of the jaw associated with oral bisphosphonate treatment for osteoprosis.
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Bone Density ; Diphosphonates ; Female ; Humans ; Jaw ; Osteonecrosis ; Osteoporosis ; Polymethacrylic Acids ; Prevalence

BACKGROUND: There is an increasing interest in physical activity as a preventive and/or therapeutic option of non alcoholic fatty liver disease (NAFLD). The aim of this study was to examine the association between physical activity and ultrasound-diagnosed NAFLD. METHODS: From April to June 2007, 198 clients who had consumed alcohol less than 140 gram per week among 598 clients who visited a general hospital for medical check-up were enrolled in this study. Clinical, biochemical variables and physical activity were compared. Physical activity was measured by self-reported questionnaire using IPAQ-short form in Korean version. Multiple logistic regression analysis was used to identify independent association. RESULTS: The prevalence of NAFLD was significantly lower in the physical active group (more than 1500 MET- minutes per week) compared to the inactive group (9.6% vs 19.2%, P<0.05). This association was not attenuated when adjusted for age, BMI, HDL cholesterol, triglycerides, fasting glucose, and HOMA2-IR (Odds Ratio 0.23 [95% CI 0.07~0.77, P<0.05]). CONCLUSION: Compared to the physically inactive group, the risk of NAFLD was lower in the physically active group. Our data suggests that regular and moderate physical exercise can prevent the development of fatty liver disease.
Cholesterol, HDL ; Exercise ; Fasting ; Fatty Liver ; Fatty Liver, Alcoholic ; Glucose ; Hospitals, General ; Logistic Models ; Motor Activity ; Obesity ; Prevalence ; Triglycerides ; Surveys and Questionnaires

BACKGROUND: This study was carried out to determine the usefulness of regional body fat measured by dual energy X-ray absorptiometry (DEXA) by examining the relationship between regional body fat and metabolic risk factors. METHODS: A total of 98 women aged 18~65 years with central obesity (waist circumference > or =80 cm) took the evaluation for metabolic risk factors (blood pressure, fasting glucose, insulin, high sensitive c-reactive protein (hs-CRP), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR)) and the anthropometric measurement, and regional body fat measurement using DEXA. The relationship of regional body fat with the metabolic risk factors, the metabolic syndrome (MS) defined by the International Diabetes Federation and insulin resistance (IR, defined by HOMA-IR> or =2.48) were assessed. The analyses were conducted using regression and logistic regression analyses. RESULTS: After adjustment for age and total body fat (%), legs fat (%) was significantly and negatively associated with LDL-C, triglyceride, HOMA-IR, and hs-CRP, while positively with HDL-C. The 1% increase of legs fat was associated with the MS by odds ratio of 0.82 (95% C.I 0.71~0.96) and with the IR by odds ratio of 0.80 (95% C.I. 0.67~0.95). Trunk fat (%) was significantly and positively associated with LDL-C, triglycerides, and HOMA-IR. The 1% increase of trunk fat was associated with the MS by odds ratio of 1.32 (95% C.I. 1.03~1.71) and with the IR by odds ratio of 1.33 (95% C.I. 1.01~1.77). The ratio of android fat to gynoid fat was significantly and positively associated with LDL-C, triglycerides, glucose, and HOMA- IR, while negatively with HDL-C. The 0.1 increase of the ratio was associated with the MS by odds ratio of 1.66 (95% C.I. 1.07~2.60). CONCLUSION: The trunk fat, and legs fat, the ratio of android fat to gynoid fat assessed by DEXA seemed to be useful indicators to predict the metabolic risk factors in women with central obesity.
Absorptiometry, Photon ; Adipose Tissue ; Aged ; C-Reactive Protein ; Fasting ; Female ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Leg ; Logistic Models ; Obesity, Abdominal ; Odds Ratio ; Risk Factors ; Triglycerides