This study was conducted to compare the validity of obese index among body mass index(BMI), waist to hip ratio(WHR), and waist circumference(WC) and to determine which is the best in relation to cardiovascular risk factors of middle aged Korean(40-64yr).Data from the 1998 Korean Health and Nutrition Survey were used(N=3380). Anthropometric indices and cardiovascular risk factors were measured. Chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator characteristic(ROC) curves were used in the analysis. There was a significant increasing trend in WHR, systolic blood pressure(SBP), high density lipoprotein cholesterol(HDL), and fasting blood sugar(FBS) with age categories of male and in BMI, WC, WHR, diastolic blood pressure(DBP), SBP, total cholesterol(TC), low density lipoprotein cholesterol(LDL), triglycerol(TG), and FBS with those of female. Specially female had the characteristics of upper body fat and systolic blood pressure risk(p<0.05). Proportions of subjects with lifestyle factors related to cardiovascular risk in overweight or upper body fat group were higher than that of normal group. Higher proportions of subjects were practiced exercise in upper body fat group of male than in other groups. Among 7 cardiovascular risk factors in partial correlation analysis, BMI had the highest correlation coefficient in 6 risk factors in male, whereas WC in 4 risk factors in female. Mean of each obese index according to cardiovascular risk groups except smoker was higher than that of normal(p<0.05). These trends were shown in upper body fat group and female. In ROC analysis of 12 risk factors and health conditions, the largest area under curve among obese indices for risk factors were BMI in male and WHR in female. The optimal cutoff values of each index(BMI: WHR: WC) for one or more cardiovascular risk factors were 23.13: 0.89: 85.35 in male and 23.57: 0.84: 78.35 in female. The results showed that cardiovascular risk factors were prevalent in middle aged Koreans within normal limits of obese indices like another Asians. For the identification of cardiovascular risk factors of middle aged Koreans, BMI for men and WHR for women are appropriate indices. But it is recommended that BMI, WHR, and WC, all three indices should be considered, when using these indices.
Adipose Tissue ; Area Under Curve ; Asian Continental Ancestry Group ; Blood Pressure ; Body Mass Index* ; Fasting ; Female ; Hip ; Humans ; Life Style ; Lipoproteins ; Male ; Middle Aged* ; Nutrition Surveys ; Overweight ; Risk Factors* ; ROC Curve ; Waist Circumference* ; Waist-Hip Ratio*

The purpose of this study was to compare the validity of obese index among body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC) and to determine which is the best in relation to cardiovascular risk in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n = 1017). Anthropometric indices and cardiovascular risk factors were measured, and chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator Characteristic (ROC) curves were used in the analysis. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p < 0.05). Among life style factors the current smokers were prevalent in obese male (p < 0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p < 0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p < 0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p < 0.05). Among 7 cardiovascular risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC > WHR > BMI in male and BMI > WHR > WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also cardiovascular risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of cardiovascular risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.
Adipose Tissue ; Aged* ; Area Under Curve ; Asian Continental Ancestry Group ; Blood Pressure ; Body Mass Index* ; Cardiovascular Diseases* ; Female ; Humans ; Life Style ; Male ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Risk Factors* ; ROC Curve ; Waist Circumference* ; Waist-Hip Ratio*

The purpose of this study was to investigate differences in the diet with the amount and the qualitative assessment of nutrient intakes by the economic level. Data from the 1998 Korean Health and Nutrition Survey were used. Using the poverty line based on the 1998 Korean minimum cost of living, Subjects (n = 10400) were classified into high class (36.1%), middle class (40.7%) and low class (23.1%). Chi-square-test and Analysis of Variance following Duncan's multiple range test were used to test the difference in nutrient intake pattern among three groups (alpha = 0.05). The amount of nutrient intake and nutrient intake adequacy were statistically different by the economic level (p<0.01). The ratio of energy intake from carbohydrate is higher than the criteria of WHO recommendation in all economic levels. Especially people in the low class depended much on the carbohydrate for the energy intake. The ratio of energy from the protein and fat are lower in the middle and low class than that of the high class. The Intake level of calcium and vitamin B2 were lower than those of the Recommended Dietary intake level, regardless of economic status. It also showed differences in major food sources of nutrients by the economic level Consequently, it seems that the nutrition policy and program should be prepared according to their economic status. Also, there should more detailed studies to find out the nutrient intake pattern, their determinant, and health consequences.
Calcium ; Diet ; Energy Intake ; Nutrition Policy ; Nutrition Surveys* ; Poverty ; Riboflavin

The objective of this study was to investigate difference in the diet by the kind of meal and the economic status. Nutrient contents at each meals were compared and differences in food intake at different meal were analyzed by economic status. Data from the 1998 Korean National Health Examination Nutrition Survey were used. Using the poverty line based on the 1998 Korean minimum cost of living, the subjects (n = 10400) were classified into high class (36.1%), middle class (40.7%) and low class (23.1%). Most nutrient intakes were obtained for main meals regardless of economic status. For high class, breakfast, lunch, dinner and snacks bring about 21, 29, 30 and 19 % of total energy intake, for middle class 22, 29, 30 and 19% and for low class 24, 30, 30 and 16%, respectively. The high-middle class people tend to get more food intakes and nutrients at dinner and snacks, while the low class at main meals. This result was associated with the consumption of a smaller number of meals and a greater number of snacks daily as the economic level was going up (p < 0.05). Meals contributed to energy, protein and fat intake, and snacks to water, retinol and vitamin C. The food intakes by food group were different at meals by economic class. Seaweed product were popular breakfast foods in both middle and low groups. Thus three meals such as breakfast, lunch and dinner still delivered most of the energy and most of the macro nutrients regardless of economic status.
Ascorbic Acid ; Breakfast ; Diet ; Eating* ; Energy Intake ; Lunch ; Meals* ; Nutrition Surveys* ; Poverty ; Seaweed ; Snacks ; Vitamin A ; Water

The objective of this study was to investigate the differences in food intake patterns by the economic status. Data from the 1998 Korean National Health and Nutrition Survey were used. Using the poverty line based on the 1998 Korean minimum cost of living, the subjects (n = 10400) were classified into high class (36.1%), middle class (40.7%) and low class (23.1%). Mean intakes for other food groups except grains, potatoes and vegetables became higher as the economic levels were going up. By the family size, it was found that intakes of grains and fishes were different (p < 0.05). By the economic status, intakes of fruits (p < 0.05), meats (p < 0.05) and fishes (p < 0.01) were different. There were no significant differences in consumed types of food by the economic status. Rice was the most prevalent food in all classes and its intakes increased as the economic status was going down. In the dietary patterns of main food group (GMDVF: Grain, Meats, Dairy, Vegetable and Fruit), the pattern except dairy (11011) revealed the highest proportion in high-middle class while the patterns without dairy and fruit food groups (11010) had the highest proportion in low class. The proportions of subjects with the low dietary diversity score (DDS) increased as economic status was going down (p < 0.01). The food groups that most people do not consume were the dairy and fruit group. Proportions of people who missed one or more groups increased as economic status was going down. The high dietary variety score (DVS) also was linked to a high score on the DDS and high class (p < 0.01). Thus the intakes of the dairy and fruits product should be increased in all classes. The low class especially had worse quality of food intakes pattern than that of the high or middle class. The nutrition policy and education programs need to be established according to the economic status.
Edible Grain ; Eating* ; Education ; Family Characteristics ; Fishes ; Fruit ; Meat ; Nutrition Policy ; Nutrition Surveys* ; Poverty ; Solanum tuberosum ; Vegetables

BACKGROUND: Urinary tract infections (UTIs) are the most frequent nosocomial infections and are frequently associated with indwelling urinary catheters. It is known that adherence to standard infection control measures for urinary catheters can reduce UTIs in hospitals. This study was performed to evaluate the effect of education in reducing catheter-related UTIs (CR-UTIs) in intensive care units (ICUs) of a university hospital. METHODS: CR-UTIs were prospectively monitored for all patients with indwelling urinary catheters in ICUs from July 2006 through December 2007. Recommendations based on previously known guidelines for catheter insertion, catheter management, and specimen collection to prevent CR-UTIs were formulated and educated in March 2007. Knowledge and adherence level were evaluated before and after educating healthcare workers about the recommendations using questionnaire. Changes in knowledge and adherence level before and after education were compared by Chi-square test. Changes in the rate of CR-UTIs and urinary catheter utilization ratios were also analyzed by Fisher's exact test. RESULTS: After education, knowledge level of and adherence level to most of the recommendations were improved significantly. The rate of CR-UTIs significantly decreased by 48% from 7.43/1,000 catheter-days before intervention to 3.87/1,000 catheter-days after intervention (P=0.02). CONCLUSION: Surveillance for nosocomial infections and education for standard infection control measures are very important in preventing CR-UTIs in ICUs.
Catheters ; Cross Infection ; Delivery of Health Care ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Prospective Studies ; Specimen Handling ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Surveys and Questionnaires

Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.
Diagnosis ; Diagnosis, Differential ; Exanthema* ; Hematuria* ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Nephrotic Syndrome ; Penicillins ; Pneumonia* ; Prenatal Care ; Prenatal Diagnosis ; Serologic Tests ; Syphilis, Congenital*

We report two cases of aggressive thyroid lymphoma in elderly patients that presented as Epub ahead of print large infiltrative thyroid masses with extensive invasion to adjacent structures including trachea, esophagus, and common carotid artery. Ultrasonography displayed irregular shaped, heterogeneous hypoechoic mass, mimicking anaplastic carcinoma. Computed tomography showed heterogeneously enhancing mass compared to surrounding muscles without calcification and hemorrhage. After biopsy, the masses were histopathologically diagnosed as lymphoma. Aggressive primary thyroid lymphoma is rare; therefore, here we report its image features, with emphasis on ultrasonographic findings, and discuss its differential diagnosis.
Aged* ; Biopsy ; Carcinoma ; Carotid Artery, Common ; Diagnosis, Differential ; Esophagus ; Hemorrhage ; Humans ; Lymphoma* ; Multidetector Computed Tomography ; Muscles ; Thyroid Gland* ; Trachea ; Ultrasonography

A 48-year-old woman was incidentally found to have bilateral adrenal masses, 2.8 cm in diameter on the right, and 2.3 cm and 1.7 cm in diameter on the left, by abdominal computed tomography. The patient had a medical history of hypertension, which was not being controlled by carvedilol, at a dose of 25 mg daily. She presented with signs and symptoms that suggested Cushing Syndrome. We diagnosed adrenocorticotropic hormone (ACTH)-independent Cushing Syndrome based on the results of basal and dynamic hormone tests. Adrenal vein sampling (AVS) was performed to localize a functioning adrenal cortical mass. AVS results were consistent with hypersecretion of cortisol from both adrenal glands, with a cortisol lateralization ratio of 1.1. Upon bilateral laparoscopic adrenalectomy, bilateral ACTH-independent adrenal adenomas were found. The patient's signs and symptoms of Cushing Syndrome improved after surgery just as the blood pressure was normalized. After surgery, the patient was started on glucocorticoid and mineralocorticoid replacement therapy.
Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocorticotropic Hormone ; Blood Pressure ; Carbazoles ; Cushing Syndrome ; Female ; Humans ; Hydrocortisone ; Hypertension ; Propanolamines ; Veins

PURPOSE: Establishing the preoperative stage of colorectal cancer is of primary importance in determining the management and the operative procedure. A comparative study of preoperative evaluation of colorectal cancer is necessary for proper management. METHODS: This study reports a 7 years' experience using another two species of CT for preoperative staging. One species of CT (1989, Delta 2060, Technicare, USA) was used from January 1990 to December 1992; the other species of CT (1992, Highlight Advantage, General Electric Company, USA) was used from January 1993 to December 1997. This study included retrospective analysis of 237 cases of colorectal cancer from January 1990 to December 1997. In first group, the preoperative stage evaluation was done with a much older species of CT from January 1990 to December 1992; in the other group, the preoperative stage evaluation was done with a newer species of CT from January 1993 to December 1997. RESULT: The accuracy & sensitivity of preoperative staging between the two groups showed no significant differences. CONCLUSION: CT is recommended in the preoperative staging of rectal cancer and as an aid in choosing the appropriate therapy. In addition to CT, transrectal ultrasonography and MRI are recommend for improving the accuracy of preoperative staging in assessing local invasion by cancer.
Colorectal Neoplasms* ; Magnetic Resonance Imaging ; Rectal Neoplasms ; Retrospective Studies ; Surgical Procedures, Operative ; Ultrasonography