Dengue fever is an acute febrile illness caused by dengue virus infection. Found predominantly in tropical urban areas, dengue virus is transmitted to humans by a female mosquito vector, Aedes aegypti. The clinical features of dengue fever include fever, headache, skin rash and bleeding. These symptoms are usually mild and not fatal, but dengue hemorrhagic fever is life threatening without proper management. The diagnosis of dengue fever can be established with a dengue virus-infected cell culture or with isolated dengue IgM. No specific treatment exists for dengue fever except for symptomatic management. With the recent global increase of dengue fever incidence, the number of cases of dengue fever in returning travelers is on the increase in Korea. Therefore, it is possible that Korean primary physicians will confront dengue fever cases. We report two cases of dengue fever that we experienced in the Department of Family Medicine in 2007.
Aedes ; Cell Culture Techniques ; Culicidae ; Dengue ; Dengue Hemorrhagic Fever ; Dengue Virus ; Exanthema ; Female ; Fever ; Headache ; Hemorrhage ; Humans ; Immunoglobulin M ; Incidence ; Korea

BACKGROUND: It is well recognized that thyroid hormone stimulates bone turnover, increasing bone resorption, thus affecting bone mineral density, but few data are available on untreated subclinical hypothyroidism. The aim of this study was to examine whether bone mineral density is increased in postmenopausal subclinical hypothyroidism patients compared with postmenopausal normal thyroid function women, and to evaluate the relationship between thyroid hormones (TSH, FT(4)) and bone mineral density or various biochemical markers of bone metabolism. METHODS: This was a cross sectional study of 132 postmenopausal women aged from 51 to 70 who undertook health screening program in Pundang CHA general hospital from 1996 to 2001. They were divided into two groups; subclinical hypothyroidism group (n=52) and normal thyroid function group (n=80) matched by age. RESULTS: The total bone mineral density was significantly increased in the subclinical hypothyroid group than in the normal group (P<0.05). The serum osteocalcin was lower in the subclinical hypothyroidism group (P<0.05), but neither the alkaline phosphatase nor the deoxypyridinoline showed any significance. For all participants in this study, TSH, but not FT(4), exhibited significant correlation with the total bone mineral density (r=0.188, P<0.05), and with the osteocalcin (r=-0.191, P<0.05). Multiple regression analysis identified the TSH as an independent predictor of the total bone mineral density (beta=0.0410; P< 0.05). CONCLUSION: This study indicated that subclinical hypothyroidism is one of the factors which can elevate bone mineral density in postmenopausal women.
Aged ; Alkaline Phosphatase ; Amino Acids ; Biomarkers ; Bone Density ; Bone Resorption ; Female ; Hospitals, General ; Humans ; Hypothyroidism ; Mass Screening ; Osteocalcin ; Thyroid Gland ; Thyroid Hormones

BACKGROUND: The present study purposed to execute group temperance education for heavy drinkers, and to examine how much the participants' drinking behavior is improved. METHODS: We ran a drinking class composed of 4 sessions of group temperance education with 40 male heavy drinkers selected through the case management program of the National Health Insurance Corporation, and compared their drinking behavior before, right after, and 12 weeks after the class. RESULTS: The mean (SD) drinks per week was 4.8 (1.8) before the drinking class, 3.3 (2.3) (P<0.001) right after the completion of the class, and 3.6 (2.2) (P<0.001) 12 weeks after the class, showing a significant decrease. The mean (SD) alcohol intake per drink also decreased significantly from 14.4 (15.6) drinks before the drinking class to 9.3 (15.5) (P<0.001) right after the completion of the class and to 12.0 (16.6) (P<0.001) 12 weeks after the class. The mean (SD) alcohol use disorder identification test score improved significantly from 27.7 (6.3) before the drinking class to 17.8 (11.1) (P<0.001) right after the completion of the class and 20.5 (8.8) (P<0.001) 12 weeks after the class. The number of heavy drinkers decreased significantly from 40 (100.0%) before the drinking class to 26 (65.0%) right after the completion of the class and 28 (70.0%) 12 weeks after the class (P<0.001), and the number of binge drinkers also decreased significantly from 40 (100.0%) before the drinking class to 27 (67.5%) right after the completion of the class and 28 (70.0%) 12 weeks after the class (P<0.001). CONCLUSION: The results of this study showed that group temperance education by primary care physicians improved heavy drinkers' drinking behavior.
Case Management ; Drinking ; Drinking Behavior ; Humans ; Male ; National Health Programs ; Physicians, Primary Care ; Temperance

BACKGROUND: Many clinical measures have been used to assess fall risk in elderly adults. The first objective of this study was to assess the clinical availability of maximal step length (MSL) as a measurement predicting falling probability in future. The second objective of this study was to try to find out how to use MSL more easily in a clinical setting. METHODS: The study population consisted of 50 community-dwelling people (> or =60 yrs). Demographic data were reviewed by self-recorded questionnaire and MSL, US and TUG had been done when the subjects visited a clinic in March and April 2004. They revisited the clinic after one year and information of fall incidence was obtained and their visual acuity was examined. To examine the association between many performance tests (MSL Unipedal stance, Timed up and go) and their real falling after tests, we analysed data by Mann-Whitney rank Test, pearson correlation and multiple regression. RESULTS: The average MSL predicted future falling (P-value 0.025), but Unipedal stance, Timed up and go did not. The predicting ability of MSL was preserved using many MSL measures (average MSL corrected by leg length and height, one direction measure among six directions of MSL, and average of left and right three directions of MSL). CONCLUSION: This study showed that MSL had the ability to predict elderly adults' falling in future. And this study showed that MSL can be used more easily in a clinical setting.
Adult ; Aged ; Humans ; Incidence ; Leg ; Visual Acuity ; Surveys and Questionnaires

BACKGROUND: The purpose of this study was to evaluate weight reduction effect of topiramate on Korean overweight epileptic patients. METHODS: A total of 45 adult overweight epileptic subjects taking topiramate who visited an epilepsy clinic of Dongsan Medical Center, Daegu, Korea, were enrolled for this study. Anthropometric data were collected whenever they visited the clinic in 12 weeks. None of subjects participated in a non-pharmacological weight-loss program. This study compared the weight change of Korean overweight epileptic subjects with 75 mg or less of topiramate (group A) and those with 100 mg or above of topiramate (group B). RESULTS: The mean body weight at 12 weeks was significantly reduced by 2.3+/-2.1 kg in group A and 5.4+/-3.2 kg in group B than the baseline body weight (P<0.05). Weight loss of 5% and 10% of the baseline weight were achieved by 36.4% and 0% in subjects of group A, and 65.2% and 13.0% in group B, respectively. Weight changes were significantly different at 4, 6, 8 and 12 weeks between group A and B (P<0.05). Improvements were observed in blood pressure, lipid profiles and fasting glucose in group A or B. CONCLUSION: In topiramate treatment of Korean overweight epileptic patients, weight change was more significant in subjects with 100 mg or above of topiramate than in subjects with 75 mg or less. Further investigation of topiramate's efficacy and safety in Korean overweight subjects is needed.
Adult ; Blood Pressure ; Body Weight ; Epilepsy ; Fasting ; Fructose ; Glucose ; Humans ; Korea ; Overweight ; Weight Loss

BACKGROUND: Upper gastrointestinal endoscopy is a very important and highly sensitive method to detect gastroduodenal lesions. But the investigation and diagnosis of gastrointestinal diseases might be delayed by discomfort, pain and anxiety in patients during endoscopy. This study was performed to evaluate the effect of family member's attendance on relief of discomfort in patients and to identify the predictors for pain and discomfort during upper gastrointestinal endoscopy. METHODS: From July to August 2005, 147 clients who underwent gastrointestinal endoscopy were enrolled in this study. The subjects were randomly grouped into family-attended (n=70) group and non-family-attended group (n=77). The patients recorded their pain and discomfort during endoscopy by Visual-Analogue Scale (VAS) score. And also the client's demographic characteristics and endoscopy related factors (procedure duration, previous endoscopy experience, biopsy, endoscopist etc.) were evaluated. We studied the relationship between the various characteristics and discomfort during endoscopy. RESULTS: There were no significant differences of clients' demographic characteristics and endoscopy related factors between the two groups. There was a significant difference of VAS scores between the family-attended group (3.51+/-1.90) and non-family-attended group (4.35+/-2.10) (P= 0.012). Oxygen saturation and pulse rate during the procedure were lower in the family-attended group than in the non-attended group. Recipients' demographic characteristics and various factors related with the procedure (waiting time, biopsy, and previous experience, etc) were not associated with the degree of discomfort. CONCLUSION: Family member's attendance decreased pain and discomfort during endoscopy. The recipients' demographic characteristics and factors related to the procedure had no influence on the degree of discomfort during endoscopy. In conclusion, attendance of a family member should be considered during endoscopy in order to decrease pain and discomfort during the procedure.
Anxiety ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastrointestinal Diseases ; Heart Rate ; Humans ; Oxygen ; Pain Measurement

Myalgia, muscle weakness, muscle cramping, muscular rigidity and elevated levels of serum creatinine kinase (CK) are very common in patients with hypothyroidism. However, these symptoms are not clinically serious in most cases and are not found in primary care. So far, 5 Cases with hypothyroid myopathy have been reported in the Korean literature. However, it is not reported that this case has been found in primary care or in periodic health examination. We report a case of hypothyroid myopathy that was presented with exercise-induced myalgia. This case was diagnosed as hypothyroid myopathy through abnormal thyroid function test and elevated levels of serum CK and myoglobin in periodic health examination. Muscle symptoms and laboratory abnormality were improved only with thyroid hormone replacement therapy.
Creatine Kinase ; Creatinine ; Hormone Replacement Therapy ; Humans ; Hypothyroidism ; Muscle Cramp ; Muscle Rigidity ; Muscle Weakness ; Muscles ; Muscular Diseases ; Myoglobin ; Myxedema ; Phosphotransferases ; Primary Health Care ; Rhabdomyolysis ; Thyroid Function Tests ; Thyroid Gland

BACKGROUND: This study was to verify the necessity of a control program developed to improve compliance, by conducting a research on the status of medication compliance in the elderly with chronic diseases in rural area and analyzing the related variables. METHODS: The organized questionnaire and pill-count were used to collect information on personal details, physical status, drugs taken in the elderly over 65 years old suffering from more than two chronic diseases in one rural area. RESULTS: The mean age of the subjects was 73.13+/-6.36 (65~93), and the number of the subjects in compliance group was 60 (77.9%) and the accuracy of self-report which was identified by pill-count was 0.86. Polypharmacy and visiting several clinics were the main factors that decided a low- degree of compliance, with OR of 5.92 (95% CI 1.11~31.44, P=0.037), and 4.25 (95% CI 1.03~17.53, P=0.045), respectively. CONCLUSION: Systematic efforts are necessary and plans must be established without delay to increase compliance in the elderly in the rural, expansively to manage chronic diseases in stay-at-home elders.
Aged ; Chronic Disease ; Compliance ; Humans ; Medication Adherence ; Polypharmacy ; Republic of Korea ; Stress, Psychological ; Surveys and Questionnaires

BACKGROUND: Neck shoulder pain (NSP) was highly prevalent even among the adolescents in previous Western studies. However, the prevalence among Korean adolescents was seldom studied and the factors associated with NSP were controversial. METHODS: A self-administered questionnaire asking the presence of NSP, restriction in daily activities due to NSP, behavioral characteristics, and psychological factors was given to 1,232 adolescent enrolled in high schools. Finally, 1,194 providing adequate responses to the questionnaire were included. NSP occurring once a week or more over the last 6 months was defined as a significant NSP and the association between the significant NSP and the studied variables was estimated using multiple logistic regression analysis. RESULTS: The prevalence of NSP and the significant NSP were 82.9% and 33.4%, respectively. The girls (40.6%) were experiencing the significant NSP more than the boys (26.0%). Restriction in daily activities due to NSP was very common and 74.8% of the girls and 65.2% of the boys reported study disturbance. The factors associated with higher risk significant NSP in the boys were higher BMI (25> or =kg/m2), moderate stress, and fairly poor or poor self-assessed physical condition with odds ratios (95% confidence intervals) of 1.86 (1.02~3.40), 1.74 (1.03~2.97), and 2.30 (1.26~4.19), respectively. In the girls, a longer (<75% of total sitting time) time of sitting in desk/chair of the inadequate height was associated with a higher risk of the significant NSP (odds ratio: 1.59, 95% confidence interval: 1.05~2.39). CONCLUSION: The prevalence of NSP in Korean adolescents was very high, suggesting that active efforts to prevent NSP in Korean adolescents would be needed with a consideration of different risk factors between girls and boys.
Adolescent ; Humans ; Logistic Models ; Neck ; Neck Pain ; Odds Ratio ; Prevalence ; Risk Factors ; Shoulder ; Shoulder Pain ; Surveys and Questionnaires

BACKGROUND: We aimed to evaluate the effect of school- based obesity prevention and management program applied to adolescents in a middle school on body mass index (BMI), weight-related attitude, eating behavior and physical activity of adolescents. METHODS: A total of 664 adolescents (14.7+/-0.9 years old) in a middle school located in Busan were study subjects. The obesity prevention and management program was conducted for 6 months, from March to September, 2005. Their weight and height were measured and their weight-related attitude, eating habit and physical activity were assessed using a questionnaire at baseline and after 6 months. Their weight status was classified into under-, normal-, and overweight according to their BMI at baseline. RESULTS: The prevalence of underweight and overweight was 6.2% and 19.3%, respectively. Among the adolescents with overweight, the BMI significantly decreased after 6 months compared to the BMI at baseline (P < 0.05), while the BMI was not significantly changed over 6 months among the under- and normal weight groups. The adolescents were more likely to become highly concerned about obesity-related problems (P=0.002) and actively participating in obesity prevention program (P=0.007) after 6 months compared to those attitude at baseline. The BMI significantly decreased in the adolescents whose eating behavior or physical activity were improved compared to their counterparts (P < 0.05). CONCLUSION: The 6-months program for obesity prevention and management seemed to reduce BMI in overweight adolescents and raise concern about obesity related problems and promote participation in obesity prevention program in adolescents as a whole. Further long-term intervention studies need to be implemented.
Adolescent ; Body Mass Index ; Eating ; Feeding Behavior ; Humans ; Clinical Trial ; Motor Activity ; Obesity ; Overweight ; Prevalence ; Thinness ; Surveys and Questionnaires