BACKGROUND: The most important thing to prevent diseases and to promote health is to change or remove health risk factors. One of the trials to improve health status by changing the health risk factors is to appraise health risk factors and to counsel about these factors during the health examination. This study is aimed to evaluate the effects of the 'health examination' on changes of health risk factors. METHODS: The medical records of the clients who have taken health examinations more than twice from June 1991 to March 1996 at a health examination center were reviewed. Those health risk factors were compared between pre- and post- health examination. RESULTS: The selected medical records accounted to 1,045. The study subjEcts consist of 758(72.5%) male. Mean age is 47.9+/-7.6 years(range 18~80). The health risk factors before health examination consisted of smoking(39% ), non-exercise(34% ), negativity of HBsAb(29.1%), obesity(18.3%), irregular diet habit(17.6%), high salt ingestion(14.1%), alcohol(1%). Also high cholesterolemia(46.2%), high blood pressure(10.7%), high uric acidemia(7.1%), high glycemia(1.6%) were found. The health risk factors such as smoking drinking, cholesterolemia, uric acidemia, blood pressure seemed to be controlled well. But, the factors like exercise, diet habit, salt ingestion, HBsAb, obesity, glucose appeared not to be controlled adequately. CONCLUSIONS: Behavioral changes to avoid health risk factors after periodic health examination were shown only In some kinds of health risk factors such as smoking and alcohol drinking and in males or those who showed high health risk factor score(total score > 6) in the first health examination.
Alcohol Drinking ; Blood Pressure ; Diet ; Drinking ; Eating ; Food Habits ; Glucose ; Health Status Indicators ; Humans ; Male ; Medical Records ; Obesity ; Risk Factors* ; Smoke ; Smoking

The national health screening program of Korea was launched in 1980. The nationwide screening program changed its target diseases to chronic diseases such as hypertension and diabetes in 1988, and the national cancer screening program was expanded to cover a larger target population in 2004. In 2007, the national health screening program launched new programs that target those at transitional ages (40- and 66-year-olds), infants, and children. These developments have been intended to promote the level of public health by reducing the mortality and/or morbidity of target diseases and about 66% of the target population was reported to have participated in the screening program in 2009. In spite of continuous efforts, the current national screening program has several limitations: 1) inequity of screening by socioeconomic status, 2) lack of follow-up care after screening, 3) lack of evidence of its effects and the types of screening items, 4) lack of evaluation and quality control of screening institutes and hospitals, and 5) the obscure role of private screening programs. To achieve the goal of a national screening program, adequate screening guidelines, an appropriate follow-up program, and increased utilization of screening test results should be also emphasized.
Academies and Institutes ; Case Management ; Child ; Chronic Disease ; Early Detection of Cancer ; Health Services Needs and Demand ; Humans ; Hypertension ; Infant ; Korea ; Mass Screening ; Public Health ; Quality Assurance, Health Care ; Quality Control ; Social Class

BACKGROUND: The prevalence of obesity, abdominal obesity and metabolic syndrome is important for health policies and clinical practice. The aim of study is to estimate the prevalence of obesity, abdominal obesity and metabolic syndrome among older than 65 years in general population and identify the differences by gender. Additionally, we examined the prevalence of the abnormality of metabolic components by sex. METHODS: We analyzed data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2007. The subjects of this study include persons over 65 years. We used data about demographics, chronic diseases, medications and blood laboratory results. RESULTS: The prevalence of obesity, abdominal obesity and metabolic syndrome in elderly women was 46.9%, 56.3% and 46.7% (International Diabetes Federation [IDF] criteria) respectively. In elderly men, 23.1%, 26.6% and 21.7% (IDF criteria). The prevalence of metabolic syndrome by modified ATP III was 63.2% in elderly women and 41.7% in elderly men. The prevalence of these was significantly higher in women elderly other in men elderly (P < 0.001). The abnormality of HDL-C among the individual metabolic components was significantly higher in women elderly than in men elderly. The prevalence of HDL-C abnormality in women elderly reached 79.9%. CONCLUSION: The prevalence of obesity, abdominal obesity and metabolic syndrome was higher in Korea than US and Europe, and higher among women elderly than men elderly. Recent increase in prevalence of these might be a public health problem.
Adenosine Triphosphate ; Aged ; Chronic Disease ; Demography ; Europe ; Female ; Health Policy ; Humans ; Korea ; Male ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Prevalence ; Public Health

Adipose tissue, where various metabolic hormones are secreted, plays a role in metabolizing different substances including androgen. Within fat tissue, enzymes such as aromatase and aldo-keto reductase 1C are responsible for metabolizing testosterone into estrogen and 5-dihydrotestosterone into inactive metabolites. Adipose tissue can also affect the secretion of gonadotropin, which influences the formation of androgen in the testes. At the same time, androgen has an impact on the distribution and proliferation of adipose tissue. The adrenoreceptors for catecholamines, which have been proven to play an essential role in controlling lipolysis, function by being up-regulated by androgens. Furthermore, androgens regulate the activity of lipoprotein lipase, a key enzyme involved in intracellular esterification of adipose tissue.
Adipose Tissue ; Alcohol Oxidoreductases ; Androgens ; Aromatase ; Catecholamines ; Esterification ; Estrogens ; Gonadotropins ; Humans ; Lipolysis ; Lipoprotein Lipase ; Male ; Oxidoreductases ; Testis ; Testosterone

Screening can effectively reduce mortality and morbidity in some diseases. In Korea, a practical national screening program for chronic disease was launched in 1995 and several problems were discussed. The program focused primarily on disease detection without follow-up care. In addition, the test items were uniform regardless of subject's age, sex, or risk factors; and people with low socioeconomic status were excluded. To improve the quality of program, a new national screening program called the "National Screening Program for Transitional Ages (NSPTA)" was initiated in 2007. It targeted two age groups, ages 40 and 66, because these ages are important transition periods in one's lifecycle. Follow-up care and education for lifestyle modification has been intensified; screening tests for mental health problems and osteoporosis have been introduced. The pool of eligible participants has been expanded to include people supported by Medicaid. This review aimed to describe the contents, process, and characteristics of the NSPTA and to compare it with the previous program. In addition, some preliminary results from 2007 to 2009 were presented. Lastly, we suggest several points that need to be considered to improve the program such as enhancement of participation rates, necessity of specialized committee and research for current screening program to be supported by evidence.
Age Factors ; Delivery of Health Care ; Humans ; *Mass Screening ; Primary Prevention ; Republic of Korea ; Risk Factors ; Sex Factors

Recently, thyroid cancer survivors are rapidly increasing in Korea, up to 21% of 1,234,879 total cancer survivors in 2012. The survival rate after thyroid cancer treatment is high, but many of the survivors suffer from fatigue, depressive mood and anxiety. Rarely, thyroid cancer treatment can result in long-term complications such as voice change and hypocalcemia. Thyroid-stimulating hormone suppression for preventing recurrence of thyroid cancer might lower bone density and increase risk of cardiovascular diseases including atrial fibrillation. For thyroid cancer survivorship care-management of such long-term complications, comorbid conditions and psychosocial problems, second primary cancer screening, promotion of healthy behaviors, support for family caregivers, role of primary care physicians is important. Systematic shared care between oncologists and primary care physicians is expected. And further research to generate evidence regarding effective management of thyroid cancer survivors is needed.
Anxiety ; Atrial Fibrillation ; Bone Density ; Cardiovascular Diseases ; Caregivers ; Fatigue ; Humans ; Hypocalcemia ; Korea* ; Long-Term Care ; Mass Screening ; Neoplasms, Second Primary ; Physicians, Primary Care ; Recurrence ; Survival Rate ; Survivors* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin ; Voice

BACKGROUND: Influenza vaccine coverage among the elderly is important for informed vaccination policies and programs. There are few studies that define influenza coverage in the elderly in South Korea. The aim of this study is to examine influenza vaccination coverage among those 65 years old and older in South Korea over the 2004-2005 influenza season and to identify the socioeconomic and clinical factors associated with vaccination. METHODS: We analyzed data retrieved from The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 conducted by the Korea Centers for Disease Control and Prevention. Subjects included in this study were older than 65 years. We used questionnaires to obtain information regarding demographics, chronic diseases, and individual health behavioral risk factors. Univariate analysis, logistic regression, and trend test were performed. RESULTS: There were 1,097 persons included in this study. Influenza vaccination among those 65 years old and older was 77.2 %. There was no difference of coverage by sex, education level, and income status. For elderly females, the moreunheal thy lifestyle (currently smoking, heavy alcohol use, and no exercise) that was practiced, the less likely they wereto be vaccinated (p for trend=0.007). CONCLUSION: The influenza vaccination coverage rate among the elderly in South Korea during the 2004-2005 flu season was relatively high compared to that of Europe (19.3-26.5 %) during the same season. Nevertheless, the coverage rate in elderly women with unhealthy lifestyle was not satisfactory causing them to be more vulnerable to related illnesses than those who practiced a healthy lifestyle. To prevent influenza related illnesses, clinicians should, in particular, encourage vaccination in those with an unhealthy lifestyle, as well as, lifestyle modification.
Aged ; Centers for Disease Control and Prevention (U.S.) ; Chronic Disease ; Cross-Sectional Studies ; Demography ; Europe ; Female ; Health Behavior ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Life Style ; Logistic Models ; Nutrition Surveys ; Surveys and Questionnaires ; Republic of Korea ; Risk Factors ; Seasons ; Smoke ; Smoking ; Vaccination

BACKGROUND: Many clinical measures have been used to assess fall risk in elderly adults. The purpose of this study was to assess the interrelationship of maximal step length (MSL) measurement as protective strategies and risk factors of falls. METHODS: The study population consisted of 149 community-dwelling people (> or = 60 yrs). Demographic data, depression degree (GDS-short form), fatigue degree (revised Chalder's fatigue scale) were reviewed by self-recorded questionnaire. K-MMSE, MSL, US and TUG were done when they visited our clinic. We examined whether MSL was correlated with the six leg-directions and was related to other measures to evaluate fall risk. To examine the association between MSL and other variables, we analyzed data by T-test, ANOVA and multiple regressions. RESULTS: The MSLmean correlated highly with each leg- direction MSL (correlation coefficient, r=0.771~0.941, P<0.01), US (r=0.392, P<0.01) and TUG (r=-0.608, P<0.01). The MSL(mean/L) (MSL(mean), leg length adjusted) correlated strongly with frequent fall (P=0.005). Also, the MSL(mean/L) had a tendency to be low in the elderly, females, in those with regular exercise, widowed or divorced, DM, stroke, dementia suspicion, inclination toward depression, arthritis and frequent falls, but higher score on fatigue groups. Age (P<.001), sex (P=0.001), DM (P<.001), frequent falls (P= 0.017), dementia suspicion (P=0.016), and arthritis (P= 0.024) variables were related with MSL(mean/L) when we examined these variables by multiple regression analysis. CONCLUSION: MSL was correlated highly with other functional performance test and DM, age, sex, frequent fall, dementia suspicion, and arthritis variables for fall risk.
Adult ; Aged ; Arthritis ; Dementia ; Depression ; Divorce ; Fatigue ; Female ; Humans ; Leg ; Risk Factors ; Stroke ; Widowhood ; Surveys and Questionnaires

BACKGROUND: Many clinical measures have been used to assess fall risk in elderly adults. The purpose of this study was to assess the interrelationship of maximal step length (MSL) measurement as protective strategies and risk factors of falls. METHODS: The study population consisted of 149 community-dwelling people (> or = 60 yrs). Demographic data, depression degree (GDS-short form), fatigue degree (revised Chalder's fatigue scale) were reviewed by self-recorded questionnaire. K-MMSE, MSL, US and TUG were done when they visited our clinic. We examined whether MSL was correlated with the six leg-directions and was related to other measures to evaluate fall risk. To examine the association between MSL and other variables, we analyzed data by T-test, ANOVA and multiple regressions. RESULTS: The MSLmean correlated highly with each leg- direction MSL (correlation coefficient, r=0.771~0.941, P<0.01), US (r=0.392, P<0.01) and TUG (r=-0.608, P<0.01). The MSL(mean/L) (MSL(mean), leg length adjusted) correlated strongly with frequent fall (P=0.005). Also, the MSL(mean/L) had a tendency to be low in the elderly, females, in those with regular exercise, widowed or divorced, DM, stroke, dementia suspicion, inclination toward depression, arthritis and frequent falls, but higher score on fatigue groups. Age (P<.001), sex (P=0.001), DM (P<.001), frequent falls (P= 0.017), dementia suspicion (P=0.016), and arthritis (P= 0.024) variables were related with MSL(mean/L) when we examined these variables by multiple regression analysis. CONCLUSION: MSL was correlated highly with other functional performance test and DM, age, sex, frequent fall, dementia suspicion, and arthritis variables for fall risk.
Adult ; Aged ; Arthritis ; Dementia ; Depression ; Divorce ; Fatigue ; Female ; Humans ; Leg ; Risk Factors ; Stroke ; Widowhood ; Surveys and Questionnaires

Acute aortic dissection is an uncommon disorder which can have fatal results in the event of treatment delay or misdiagnosis. This case examines a 77-year-old woman presenting with chest pain relieved by nitroglycerin. She was referred to the emergency room with clinical suspicion of acute coronary syndrome (ACS). However, she was later diagnosed with acute aortic dissection and an emergency operation was performed with successful recovery. Aortic dissection may manifest in various ways depending on the site involved and may mimic other disorders such as ACS or pulmonary embolism. Therefore, clinicians must always be aware of aortic dissection and its different clinical manifestations must be understood.
Acute Coronary Syndrome ; Aged ; Chest Pain* ; Diagnosis ; Diagnostic Errors ; Emergencies ; Female ; Humans ; Nitroglycerin* ; Pulmonary Embolism ; Thorax*