BACKGROUND: Metabolic syndrome increases the risk for cardiovascular diseases and type 2 diabetes mellitus. Many studies have revealed that eating frequency influences the total serum cholesterol level, glucose tolerance and obesity. Hypothesizing that an increase in eating frequency decreases the prevalence of metabolic syndrome with total energy intake adjusted, we evaluated the association between eating frequency and the risk of metabolic syndrome in Koreans aged more than 20 years old. METHODS: We used the data from the 2005 Korean National Health and Nutrition Examination Survey. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III and the Asia-Pacific regional obesity guidelines. To examine the association of metabolic syndrome with eating frequency, snack frequency and meal frequency, we performed multiple logistic regression analysis adjusting for age, sex, physical activity, daily caloric intake, smoking and drinking. RESULTS: Meal frequency was associated with metabolic syndrome in the 20-45 years group (P=0.011). Eating frequency was significantly related with metabolic syndrome in the group aged more than 45 years (P=0.025). Within the subgroup of subjects more than 45 years who had one or two meals a day, snack frequency showed a significant association with metabolic syndrome (P=0.038). CONCLUSIONS: These results suggest that a decreased eating frequency is associated with a risk of metabolic syndrome, although the causal relationship is not exactly known. It would be useful to pursue this question through further studies.
Adult ; Aged ; Cardiovascular Diseases ; Cholesterol ; Diabetes Mellitus, Type 2 ; Eating ; Energy Intake ; Food Habits ; Glucose ; Humans ; Logistic Models ; Meals ; Motor Activity ; Nutrition Surveys ; Obesity ; Prevalence ; Smoke ; Smoking ; Snacks

OBJECTIVE: This study aims to develop the web-interface creator, which automatically changes the Case Report Form(CRF) web page when the protocol developer in any clinical study revises the ontology of CRF. METHODS: This study established the conceptual model of CRF on oriental and western medicine, and developed ontologies. A program was developed to produce online-based a input form through the parser that generates automatically HTML script from OWL. RESULTS: The CRF applied in this study is a draft through consensus of experts for stroke research at the Korea Institute of Oriental Medicine. The ontology of CRF consisted of Label, ControlType and Value classes and hasControl, hasValue and hasSymptoms properties. The Label is the class of question items groups, so it could have CRF questionnaire instances. The ControlType is the class that expresses controls such as checkbox, text, etc in the HTML script. The Value class represents selections for each items. Finally, the HTML script was created by XSL transformation from the OWL script. CONCLUSION: Online-based automatic interface creation, which enables immediate coping with the continuous change in the medical knowledge system, assures reduced time requirement.
Consensus ; Korea ; Medicine, East Asian Traditional* ; Strigiformes ; Stroke

OBJECTIVES: The purpose of this study was to estimate the socioeconomic costs resulting from alcohol drinking among adolescents as of 2006 from a societal perspective. METHODS: The costs were classified into direct costs, indirect costs, and other costs. The direct costs consisted of direct medical costs and direct non-medical costs. The indirect costs were computed by future income losses from premature death, productivity losses from using medical services and reduction of productivity from drinking and hangover. The other costs consisted of property damage, public administrative expenses, and traffic accident compensation. RESULTS: The socioeconomic costs of alcohol drinking among adolescents as of 2006 were estimated to be 387.5 billion won (0.05% of GDP). In the case of the former, the amount included 48.25% for reduction of productivity from drinking and hangover, 39.38% for future income losses from premature death, and 6.71% for hangover costs. CONCLUSIONS: The results showed that the socioeconomic costs of alcohol drinking among adolescents in Korea were a serious as compared with that of the United States. Therefore, the active interventions such as a surveillance system and a prevention program to control adolescents drinking by government and preventive medicine specialist are needed.
Accidents, Traffic/economics ; Adolescent ; Alcohol Drinking/*economics ; Costs and Cost Analysis ; Efficiency ; Health Services/economics/utilization ; Humans ; *Models, Economic ; Republic of Korea ; Socioeconomic Factors

Recent progress in medical informatics enables us to use medical information regardless of time or place, to make a diagnostic and therapeutic plan, according to increasing need about health of general population. There are many homepages on the web, which provides medical common senses, hospital information, and medical counselling on the web. Virtual Hospital, which offers comprehensive media information, has medical counselling program with various programs such as self-diagnosis, emergency information, drug information, Q and A, and so on. The aim of this study is to examine the content and purpose of medical counselling on the web. The subjects consisted of 150 counselings which were called 'Medical Counselling' in the Virtual Hospital for December 1996 through March 1997. Many questioners wanted to know treatment principles. to make a diagnosis, and to know specific medical knowledge, The most common questions are as follows; general and unspecified, digestive, skin, musculoskeletal problems. These findings suggests that medical counselling may be used to supplement the lack of direct medical interviews with doctors.
Counseling* ; Diagnosis ; Emergencies ; Internet* ; Medical Informatics ; Skin

BACKGROUND: Numerous studies have identified that physical activity (PA) has positive influences on quality of life. However, there has been little domestic research about the relation of PA to health-related quality of life (HRQoL) among the general population. The purpose of this study was to evaluate the effect of PA on HRQoL in Korean adults aged 40 years or over. METHODS: This cross-sectional study was based on data acquired from the Korean National Health and Nutrition Examination Survey IV. Final study subjects were 10,392 adults aged 40 years or over. According to the severity and frequency of PA, the subjects were divided into three PA groups as follows: high-activity, mid-activity, and low-activity group. We compared the HRQoL estimated by the EuroQoL 5-dimension (EQ-5D), the EQ visual analogue scale (EQ-VAS), and EQ-5D index between three PA groups. RESULTS: The odds ratios for mid-activity group and high activity group compared with low activity group were significantly decreased in the dimension of mobility of EQ-5D (mid-activity group, 0.81 [0.69-0.94]; high activity group, 0.81 [0.67-0.99]). EQ-VAS was decreased as PA level was lowered from high activity group and mid-activity to low activity group. EQ-5D index was the highest in mid-activity group and the lowest in low activity group. CONCLUSION: PA above mid-activity group showed better HRQoL compared than low activity group.
Adult ; Cross-Sectional Studies ; Humans ; Korea ; Motor Activity* ; Nutrition Surveys* ; Odds Ratio ; Quality of Life*

In this study, we found a new food additive as an natural herbal extracts against lipid digestion enzymes for the regulation of fatty acid absorption and weight control. The Water extracts of Platycodon grandiflorum and Solanum melongena. inhibited lipase activity and decresed serum total cholesterol and triglyceride concentration in mouse fed lipid emulsion. Twenty three volunteers were subjected to the intake of the herbal extracts plus the egg yolk IgY that inhibit carbohydrate digestion enzymes in gut for 50 days. In average, the treated subjects appeared to lose 1.96 kg of body weight and 3.4 kg of body fat mass during the treated period. Furthermore, Panniculus adiposus and breech size were significantly decreased during the experimental period. Above results suggested that the administration of the dietary additives composed of natural herbal extract and egg yolk IgY improve the obesity by the decrement of body weight and body fat mass.
Absorption* ; Adipose Tissue ; Animals ; Body Weight ; Cholesterol ; Dietary Supplements* ; Digestion ; Egg Yolk ; Food Additives ; Lipase ; Mice ; Obesity ; Platycodon ; Solanum melongena ; Triglycerides ; Volunteers ; Water

Problem-based Learning challenges students to be more actively involved in defining what they learn and solving the problem. When it proceeds with the Internet, the Internet program will provide learning materials and guide the clinical reasoning process. We developed the PBL casebank database on the web to facilitate development and maintenance of PBL case modules. The database has the 3-tier structure according to the form of the preexistent Internet program, and possible record forms are text, sound files, and image files. This database system is connected with web using ODBC(Qpen DataBase Connectivity) and ASP(Active Server Pages) technology on the Microsoft Windows NT server. With this PBL casebank system, we are hoping for owning medical education materials in common between universities and distance learning in medicine.
Education, Distance ; Education, Medical* ; Hope ; Humans ; Internet* ; Learning ; Problem-Based Learning*

PURPOSE: The purpose of the study was to examine the recording accuracy of faculty observers and standardized patients (SPs) on a clinical performance examination (CPX). METHODS: This was a cross-sectional study of a fourth-year medical students' CPX that was held at a medical school in Seoul, Korea. The CPX consisted of 4 cases and was administered to 118 examinees, with the participation of 52 SP and 45 faculty observers. For the study we chose 15 examinees per case, and analyzed 60 student-SP encounters in total. To determine the recording accuracy level, 2 SP trainers developed an answer key for each encounter. First, we computed agreement rates (P) and kappa coefficient (K) values between the answer key-SPs and the answer key-faculty observers. Secondly, we analyzed variance (ANOVA) with repeated measures to determine whether the mean percentage of the correct checklist score differed as a function of the rater, the case, or the interaction between both factors. RESULTS: Mean P rates ranged from 0.72 to 0.86, while mean K values varied from 0.39 to 0.59. The SP checklist accuracy was higher than that of faculty observersat the level of item comparison. Results from ANOVA showed that there was no significant difference between the percentage of correct scores by the answer key, faculty observers and SPs. There was no significant interaction between rater and case factors. CONCLUSION: Acceptable levels of recording accuracy were obtained in both rater groups. SP raters can replace faculty raters in a large-scale CPX with thorough preparation.
Checklist ; Clinical Competence ; Cross-Sectional Studies ; Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Korea ; Observer Variation ; Schools, Medical

PURPOSE: This was a cross-sectional study designed to evaluate the subjective understanding of technical terms and contents of the informed consent forms given to patients about to undergo conscious sedative upper gastrointestinal endoscopy. METHODS: A group of conveniently selected 180 patients, who were undergoing sedative endoscopy were recruited in the endoscopy procedure room in a tertiary hospital from June to July 2011. Data were collected with a structured questionnaire. RESULTS: The average number of terms exposed was 8.12 out of 10 items, the average number of terms understood well by the patients was 5.53 out of 10 items, and the average number of right answers was 3.30 out of 5 items, and the percent of correct answers ranged from 26.1% to 90.0%. The exposure to terms differed by gender, education, and previous exposure to sedative endoscopy procedures. The number of "understanding of the terms well" responses differed according to age and previous exposure to sedative endoscopy procedures, and the correct answer rate was differed by education. CONCLUSION: The understanding of the terms and knowledge about the procedures were disappointing. Therefore, sufficient explanations should be provided to the patients. While the informed consent was taken by doctors, the level of understanding should be monitored by nurses. In particular, subjects who did not have any previous experience with endoscopy procedures showed relatively lower level of understanding. We recommend that medical terms should be replaced with more common and nontechnical words in consent forms.
Comprehension ; Consent Forms ; Cross-Sectional Studies ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Informed Consent ; Tertiary Care Centers

Medicine in the twenty-first century will be different from the medicine of today. Recent changes in medical environment, such as changes in disease and mortality pattern and rapid increase in medical knowledge, require change and adaptation of medical education. The task of medical education is to help people entering medicine to prepare to meet their professional obligations in this new context. So we tried to join Problem-base learning(PBL), which challenges students to be more actively involved in defining what they learn and how they learn, and Computer-assisted learning(CAL), which uses multimedia and medical informatics as learning tools. Finally we developed Problem-oriented medical education program using the Internet. First, using simulated patient cases, we built clinical database with patients' history, physical examinations, and various laboratory findings. To provide PBL program through the Internet, we constructed client-server system using IJS(Internet Information Server) on Windows-NT settings, and made user-friendly dynamic interface with HTML, JAVA, JAVA Script and so on. PBL on the Web will make students learn effectively and actively, and offer vivid multimedia environment for medical education. We expect this PBL program to be used as an effective learning tool for residents or doctors as well as for medical students in the near future. The Internet
Education, Medical* ; Humans ; Indonesia ; Internet* ; Learning ; Medical Informatics ; Mortality ; Multimedia ; Physical Examination ; Students, Medical