BACKGROUND: Recently, in our ageing society, the change in dietary pattern and increase in obesity have caused the metabolic syndrome to increase in Korea. Because of the association of the risk of cardiovascular diseases, the metabolic syndrome must be prevented and well managed. We examined the association between the metabolic syndrome and the serum testosterone and DHEA-S concentration. METHODS: The subject of this study included 231 men aged more than 40 years old who visited the health promotion center of a university hospital from March 2004 to March 2006. We excluded the subjects who were currently on medications except for antihypertensive and hypoglycemic agents. We defined the metabolic syndrome according to the ATP III with Asia-Pacific waist circumference. To examine the association between the metabolic syndrome and the serum testosterone concentration, we used the method of multiple logistic regression analysis. RESULTS: The prevalence of the metabolic syndrome in our subjects was 32.9%. Decreased serum testosterone concentration was significantly associated with large waist circumference and high fasting blood sugar. Men with testosterone values in the upper tertile had a significantly lower risk of metabolic syndrome (OR=0.34, P=0.018). CONCLUSION: After statistical adjustment for age, smoking, income, exercise, alcohol intake, and body mass index, the serum testosterone concentration was negatively associated with the metabolic syndrome.
Adenosine Triphosphate ; Adult ; Blood Glucose ; Body Mass Index ; Cardiovascular Diseases ; Fasting ; Health Promotion ; Humans ; Hypoglycemic Agents ; Korea ; Logistic Models ; Male ; Obesity ; Prevalence ; Smoke ; Smoking ; Testosterone* ; Waist Circumference

BACKGROUND: The causes of eosinophilia are allergies, parasite infections, medications, skin diseases, and others. But, the etiologies of eosinophilia and variables associated with eosinophilia are not well known in Korea. METHODS: This study included patients in a health check up at a general hospital from May 21, 1995 until February 14, 2004. Through self-report, serology, and stool exam, variables associated with eosinophilia were tested. RESULTS: In the eosinophilic group, 5% were helminth infected, and more of C. sinensis infection were found the eosinophilic group with 3.9% compared to the non-eosinophilic group with 1.2% (P<0.05) Associated variables with eosinophilia were old age, high BMI, drinking, smoking, the season of testing helminth infections, and Clonorchiasis infection. But allergy was not associated with eosinophilia. The odds ratios for eosinophilia after adjustment were 2.280 (1.694~3.068) in helminth infections and 2.391 (1.716~3.331) in Clonorchiasis infection. CONCLUSION: In the eosinophilic group, 5% were helminth infected, and more C. sinensis infection were found. Associated variables with eosinophilia were old age, high BMI, drinking, smoking, the season of testing, helminth infections, and Clonorchisis infection. But allergy was not associated with eosinophilia.
Academic Medical Centers* ; Clonorchiasis ; Drinking ; Eosinophilia* ; Eosinophils ; Helminths ; Hospitals, General ; Humans ; Hypersensitivity ; Korea ; Odds Ratio ; Parasites ; Seasons ; Skin Diseases ; Smoke ; Smoking

BACKGROUND: Although proactive screening for sexual dysfunction in primary care has been emphasized as an important part of comprehensive care, doctors seldom ask their patients about their sexual function. Worry about patients' responses was reckoned as a major barrier, but few studies have dealt with how patients feel and what they want. This study was aimed to describe and analyze the attitudes of patients toward proactive screening for sexual dysfunction. METHODS: A set of self-administered questionnaire was given to every patients who visited a family medicine clinic in a university hospital for 2 weeks from March 16, 2005. RESULTS: A total of 185 patients were analyzed. Among them, 72.4% were willing to consult their physician when they were in trouble with their sexual function, and 84.3% said proactive screening for sexual dysfunction was necessary. Many patients did not care about 'when to be asked' and wanted to be asked in face-to-face interview rather than by a questionnaire. Sentence emphasizing that every patient is given the same question was most preferred. CONCLUSION: Patients' attitude toward proactive screening for sexual dysfunction in primary care was generally positive. Patients preferred to be asked "I ask every patient about his sexual problem. If you're OK, I ask you about your sexual problem." regardless of timing, during the interview.
Humans ; Mass Screening* ; Primary Health Care ; Surveys and Questionnaires

A retrospective cohort of adult Korean males and females was conducted to evaluate the influence of obesity on the development of hypertension and to determine the level of the body mass index at which the risk of hypertension significantly increases. The subjects of this study were 1,467 men and 944 women aged 20 to 75 yr who were normotensive at the time of their initial examinations from 1990 to 1991, who had a follow-up examination at least 1 yr after their initial examinations, or whose blood pressure status could be confirmed by reviewing their medical records until June 2000. During an average follow-up period of 6.2 yr, 234 new cases of hypertension were identified. An analysis using the Cox proportional hazards model showed that the risk of developing hypertension increased with increasing age, body mass index, and amount of daily alcohol consumption in men; and with increasing age and body mass index in women. Comparing men and women whose body mass indices were smaller than 23 kg/m2, the relative risks of hyper-tension were 2.56 times greater in men and 3.17 times greater in women, whose body mass indices were greater than 27 kg/m2. Our study confirmed that obesity is a strong risk factor for hypertension among Korean adults. In addition, high alcohol consumption may be a significant risk factor for men.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Cohort Studies ; Exercise ; Humans ; Hypertension/*etiology ; Lipids/blood ; Middle Aged ; Obesity/*etiology ; Research Support, Non-U.S. Gov't ; Retrospective Studies ; Risk Factors

BACKGROUND: Two representative groups of family physicians and oncologists were surveyed concerning their knowledge and attitudes toward cancer pain management (CPM). METHODS: A questionnaire, designed to assess knowledge (13 items) and attitudes (6 items) toward CPM, was sent to 2,200 members of Korean Association of Family Medicine and 800 members of Korean Cancer Association. RESULTS: Three hundreds and eighty eight family physicians (17.6%) and one hundred and forty seven oncologists (18.4%) responded and completed the questionnaire. They had inadequate knowledge toward CPM, especially, chance of respiratory depression, tolerance to adverse effect, ceiling effect, risk of addiction, and use of adjuvants. Most of the physicians had positive attitude toward importance of CPM, best judge of pain severity, and priority of CPM but had negative attitude toward concerns about potential problem of addiction and earlier prescription of maximum dose of opioid. Family physicians displayed more lack of knowledge about CPM in 9 of 13 items and more negative attitudes toward 4 of 6 items. Adjustment for demographic characteristics and experiences in cancer patients with pain showed that while family physicians had poor knowledge of tolerance to confusion, they had more adequate knowledge on the effect of antidepressant and had positive attitude towards best judge of pain severity and priority of CPM. Poor knowledge about CPM was rated by 66.3% of physicians as the most important barrier to adequate CPM. CONCLUSION: These findings that most of the physicians had poor knowledge and negative view toward CPM suggest a continuous need for comprehensive education program focused on CPM for physicians.
Education ; Humans ; Korea* ; Pain Management* ; Physicians, Family* ; Prescriptions ; Respiratory Insufficiency ; Surveys and Questionnaires

BACKGROUND: The optimal screening tools for hepat ocellular carcinoma are regular tests of alpha fetoprotein (aFP)and liver ultrasonography every 6 months in high risk group. To implement successful long-term project for reducing cancer-mortality,it is essential to know the reasons f or non-compliance among the high risk group. METHODS: A telephone survey was done a mong the hepatitis B surface antigen positive patient group who had not receiveda follow-up test of aFP and liver ultrasonography. This group was selected among the patients who had received health examinations from January,2002 to December,2002 at a university hospital center for health promotion, and the reasons for non-compliance were inquired. RESULTS: There were no stati stical di fferences i n educational level,economic status,age,and sex between the patient group who had taken appropriate follow-up tests and the group who had not. But there were statistically significant differences in the admission history and t ransf usi on hi st ory bet ween t he t wo groups. The reasons for non-compliance were as follows:1. ignorance to the significance of follow-up examination (41.7%),2.lack of time (27.8%),3.no specific signs of cancer (22.2%),4.high costs (5.6%),and 5.fear of discovering serious disease. CONCLUSION: It is important to have patients educated on the significance of screening and early diagnosis of hepatocellular carcinoma.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Compliance ; Early Diagnosis ; Follow-Up Studies ; Health Promotion ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Liver ; Mass Screening* ; Telephone ; Ultrasonography

BACKGROUND: CRC is an ideal target for population screening because it is a prevalent disease with an identifiable precursor lesion. This study was performed for the purpose of comparing cost-effectiveness of CRC screening strategies. METHODS: The natural history of a simulated cohort of 50- year-old Koreans in the general population was modeled with and without CRC screening until age 80 years. We evaluated 16 different screening strategies with Markov model. Cases of positive screening test results were worked up with a colonoscopy. After polypectomy, colonoscopy was repeated every 3 years. Our main outcome measurements were discounted lifetime costs, life expectancy and incremental cost-effectiveness (CE) ratio, comparing 16 different CRC screening strategies. RESULTS: In base-case analysis, compliance was assumed to be 60% with the initial screen and 80% with follow-up or surveillance colonoscopy. The non-dominated strategies were colonoscopy every 10 years (COL10), colonoscopy every 5 years (COL5) and colonoscopy every 3 years (COL3). Strategies that only included sigmoidoscopy were generally not regarded as non-dominated strategies, but sigmoidoscopy every 5 years (SIG5) showed similar cost and effects as COL10 while sigmoidoscopy every 3 years (SIG3) had similar results as COL5. Other strategies recommended by the expert panel, such as sigmoidocopy plus colon study every 5 years were less cost-effective than the alternatives. CONCLUSION: Colonoscopy is the most cost-effective strategy in Korea for colorectal cancer screening. Unfortunately, the number of physicians skilled enough to perform colonoscopy is not enough to meet the demands of screening for colorectal cancer in average-risk adults. Therefore, we consider alternative strategies such as SIG5 or SIG3.
Adult ; Cohort Studies ; Colon ; Colonoscopy ; Colorectal Neoplasms* ; Compliance ; Follow-Up Studies ; Humans ; Korea ; Life Expectancy ; Mass Screening* ; Natural History ; Sigmoidoscopy

BACKGROUND: Currently, the high quality of life associated with women's rights is strongly supported and has become an important social issue. As a result, there is an increasing need for studies concerning female sexual function. The objectives of this study was to develop a questionnaire to evaluate sexual function evaluation in Korean women. METHODS: A total of 100 married women, who visited an outpatient clinic of family medicine department of a university hospital in Seoul, were studied. After filling out the self-administered questionnaire, a face-to- face interview was done on all study subjects. The items of this questionnaire were adopted from questionnaires with proven validity and reliability. Factor analysis was done and Crohnbach's alpha was calculated. RESULTS: The items of this questionnaire were classified into 5 parts: Drive, Excitement, Sexual activity, Satisfaction, and Spouse. The total variance was 51.5%. The total Crohnbach's alpha was 0.82. The internal consistency was high. Study subjects were able to complete this questionnaire within 10 minutes. CONCLUSION: The validity and reliability of this female sexual function questionnaire was found to be acceptable. This questionnaire can be utilized as a diagnostic adjunctive tool and feedback for treatment through further studies.
Ambulatory Care Facilities ; Female* ; Humans ; Outpatients* ; Quality of Life ; Reproducibility of Results ; Seoul ; Sexual Behavior ; Spouses ; Women's Rights ; Surveys and Questionnaires

BACKGROUND: Female sexual function is influenced by much more factors than that of male and has a close relationship with psychosocial factors. A satisfying sex life has a high correlation to a happy married life. A questionnaire provides easy access to private matters and in a multidimensional manner. The objective of this study was to identify the factors related to female sexual function to help sexual adjustment in marriage. METHODS: A hundred married women living with their spouses, who visited an outpatient clinic of family medicine department of a university hospital in Seoul were studied. After filling out the self-administered questionnaire, a face-to-face interview was done on all study subjects. For multivariate analysis of the related factors, the outcome variables were a binary response of the normal female sexual cycle ?drive, lubrication, orgasm, and satisfaction. RESULTS: The multivariate analysis showed that the household income was a significant factor related to Drive (Odds Ratio: OR=0.6, 95% Confidence Interval: CI 0.4~0.9). Age was a significant factor related to Insufficient Lubrication (OR=1.1, 95% CI 1.0~1.3). Insufficient foreplay was a risk factor for Insufficient Lubrication (OR= 2.4, P=0.052). In multivariate analysis of the Orgasm related factors, the perceived health status showed an OR of 7.1 (95% CI 1.5~32.6) and both marital satisfaction and open communication showed an OR of 6.0 (95% CI 1.3~26.8) and an OR of 5.8 (95% CI 1.2~28.2), respectively. The significant related factors to Satisfaction were in order of importance of sex life, education, and open communication, with an OR of 3.6 (95% CI 1.7~7.6), 2.5 (95% CI 1.1~5.9), and 2.0 (95% CI 1.0~3.8), respectively. CONCLUSION: The positively related factors to female sexual function were good perceived health status, high marital satisfaction, placing importance in sex life, and open communication regarding sexual matters. Increasing age and household income were found to be factors adverse to female sexual function.
Ambulatory Care Facilities ; Education ; Family Characteristics ; Female* ; Humans ; Lubrication ; Male ; Marriage ; Multivariate Analysis ; Orgasm ; Outpatients* ; Psychology ; Risk Factors ; Seoul ; Spouses ; Surveys and Questionnaires

BACKGROUND: Although lack of exercise is well known to be a risk factor of osteoporosis, it is unclear whether weight-bearing exercise has different effects on bone mineral density compared to non weight-bearing exercise, and the amount of exercise needed to prevent osteoporosis is not clearly defined. This study was performed to clarify the relations between the type and the amount of exercise with BMD. METHODS: This was a cross-sectional study of 3,661 women who had undertaken health screening including BMD measurement at Health Promotion Center of SNUH between May 1997 and March 1999. Information on sociodemographic characteristics, menarche, childbirth andexercise were gathered by means of self-reported questionnaire, and BMD was measured using DEXA. RESULTS: The number of women with lumbar osteoporosis were 601 (16.4%) and femoral neck osteoporosis 372 (10.2%). Lumbar osteoporosis occurred more frequently with increasing age and age at menarche, and in menopausal women, but less frequently with increasing fat-free mass in multiple logistic regression analysis. When adjusted for age, age at menarche, menopause and fat-free mass, lumbar osteoporosis was less common in women who exercised, but the type and the amount of exercise had no bearing. Especially, lumbar osteoporosis was least common in women engaging in moderate amount of exercise. Femoral neck osteoporosis decreased significantly only in weight-bearing exercise group and in women engaging in high amount of exercise. CONCLUSION: The results of this study suggest that lumbar osteoporosis can be prevented through exercise regardless of its type and amount, and high amount or weight- bearing exercise is most effective to prevent femoral neck osteoporosis.
Adult* ; Body Composition ; Bone Density* ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Promotion ; Humans ; Logistic Models ; Mass Screening ; Menarche ; Menopause ; Osteoporosis ; Parturition ; Risk Factors ; Weight-Bearing ; Surveys and Questionnaires