BACKGROUND: The prevalence of childhood obesity in South Korea has increased owing to economic improvement and the prevailing Westernized dietary pattern. As the incidence of chronic diseases caused by obesity is also expected to increase, effective interventions to prevent childhood obesity are needed. Therefore, we conducted a Delphi study to determine the priorities of a potential intervention research on childhood obesity prevention and its adequacy and feasibility. METHODS: The two-round Delphi technique was used with a panel of 10 childhood obesity experts. The panelists were asked to rate “priority populations,”“methods of intervention,”“measurement of outcomes,”“future intervention settings,” and “duration of intervention” by using a structured questionnaire. Finally, a portfolio analysis was performed with the adequacy and feasibility indexes as the two axes. RESULTS: For priority populations, the panel favored “elementary,”“preschool,” and “middle and high school” students in this order. Regarding intervention settings, the panelists assigned high adequacy and feasibility to “childcare centers” and “home” for preschool children, “school” and “home” for elementary school children, and “school” for adolescents in middle and high school. As the age of the target population increased, the panelists scored increasing numbers of anthropometric, clinical, and intermediate outcomes as highly adequate and feasible for assessing the effectiveness of the intervention. CONCLUSION: According to the results of the Delphi survey, the highest-priority population for the research on childhood obesity prevention was that of elementary school students. Various settings, methods, outcome measures, and durations for the different age groups were also suggested.
Adolescent ; Child ; Child, Preschool ; Chronic Disease ; Delphi Technique ; Health Services Needs and Demand ; Humans ; Incidence ; Korea ; Obesity ; Outcome Assessment (Health Care) ; Pediatric Obesity* ; Prevalence

BACKGROUND: In order to evaluate the factors of compliance with a lipid lowering therapy, a prospective observational study of patients with hypercholesterolemia using rosuvastatin was carried out. METHODS: A total of 2,607 patients who were newly prescribed rosuvastatin were enrolled from 32 family physicians in Korea from March 2009 to December 2009. Of them, 301 patients were excluded due to incomplete data or follow-up compliance data. The patients were regularly observed to ascertain the compliance associated with rosuvastatin at intervals of 12 and 24 weeks. We collected risk factors for the compliance using a structured questionnaire. The criteria for evaluating compliance are to measure clinic attendance, to assess the continuity of therapy, and to calculate the percentage of doses taken. RESULTS: Among a total of 2,306 patients, the degree of compliance was 54.1%. According to logistic regression analysis, the factors for compliance with the lipid lowering drug included old age (odds ratio [OR], 2.68; 95% confidence interval [CI], 2.09 to 3.45), frequent exercise (OR, 1.76; 95% CI, 1.43 to 2.18), previous statin therapy (OR, 4.02; 95% CI, 3.22 to 5.01), hypertension (OR, 1.80; 95% CI, 1.48 to 2.19), diabetes mellitus (OR, 2.20; 95% CI, 1.69 to 2.87), concomitant medication (OR, 2.28; 95% CI, 1.88 to 2.77), and high coronary heart disease (CHD) risk category (OR, 1.82; 95% CI, 1.39 to 2.38). The compliance decreased with high low density lipoprotein cholesterol levels (OR, 0.20; 95% CI, 0.16 to 0.26). CONCLUSION: The compliance of patients using rosuvastatin was 54.1% in primary care. The factors related to higher compliance were old age, regular exercise, previous statin therapy, concomitant medication, presence of hypertension or diabetes, and higher CHD risk level.
Cholesterol ; Cholesterol, LDL ; Compliance ; Coronary Disease ; Diabetes Mellitus ; Fluorobenzenes ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Hypertension ; Korea ; Lipoproteins ; Logistic Models ; Physicians, Family ; Primary Health Care ; Prospective Studies ; Pyrimidines ; Risk Factors ; Sulfonamides ; Rosuvastatin Calcium ; Surveys and Questionnaires

OBJECTIVES: The purpose of this study was to determine the optimal master apical file size with minimal transportation and optimal efficiency in removing infected dentin. We evaluated the transportation of the canal center and the change in untouched areas after sequential preparation with a #25 to #40 file using 3 different instruments: stainless steel K-type (SS K-file) hand file, ProFile and LightSpeed using microcomputed tomography (MCT). MATERIALS AND METHODS: Thirty extracted human mandibular molars with separated orifices and apical foramens on mesial canals were used. Teeth were randomly divided into three groups: SS K-file, Profile, LightSpeed and the root canals were instrumented using corresponding instruments from #20 to #40. All teeth were scanned with MCT before and after instrumentation. Cross section images were used to evaluate canal transportation and untouched area at 1- , 2- , 3- , and 5- mm level from the apex. Data were statistically analyzed according to' repeated nested design'and Mann-Whitney test (p = 0.05). RESULTS: In SS K-file group, canal transportation was significantly increased over #30 instrument. In the ProFile group, canal transportation was significantly increased after preparation with the #40 instrument at the 1- and 2- mm levels. LightSpeed group showed better centering ability than ProFile group after preparation with the #40 instrument at the 1 and 2 mm levels. CONCLUSIONS: SS K-file, Profile, and LightSpeed showed differences in the degree of apical transportation depending on the size of the master apical file.
Dental Pulp Cavity ; Dentin ; Hand ; Humans ; Molar ; Nickel ; Stainless Steel ; Titanium ; Tooth ; Tooth Apex ; Transportation ; X-Ray Microtomography

BACKGROUND: Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice. METHODS: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression. RESULTS: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression. CONCLUSION: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome.
Aged ; Arthralgia ; Depression ; Family Practice ; Fatigue ; Female ; Humans ; Hypertension ; Leg ; Male ; Prevalence ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring ; Stroke

BACKGROUND: Consultation and referral are important characteristics of modern medicine which has become more segmented and more specialized. In particular, they give essential value to family practitioners to coordinate patients accordingly for proper care. This study analyzed the referred patients in family practices under Cheonan practice based-research network (CPBRN). METHODS: The data was collected via questionnaire in ten family clinics under CPBRN system during the four weeks from June 15, 2006 to July 12, 2006. RESULTS: The total number of referred cases was 103 (0.7%) out of a total of 14,466 office visits. Among the total, 68.9% of referred cases was physician-drived and 31.1% was patient-requested. The reason for referral were 'to get a second opinion of specialist' (34), 'high severity' (20), 'lack of examination tool' (18), 'lack of skill' (10) and 'no response to treatment' (2) in physician-drived cases, whereas in patient-requested cases, they were 'request for advanced hospital' (26) and 'want to meet specialist' (2). The patients were referred to tertiary hospital in 66.7%, secondary hospital in 15.9%, and other specialists of primary setting in 10.1%. Overall, 66.7% of the referred hospital was located in the city area. The main health problems of referred patients was divided into 'gastrointestinal' (17.5%), 'musculoskeletal' (13.6%), 'dermatology' (10.7%) and so on. The speciality consulting physicians were 'internal medicine' (34%), 'pediatrics' (13.6%), and 'orthopedic surgery' (10.7%) specialists. CONCLUSION: The referral rate of family practice in Korea was 0.7%. The main reason for referral was 'to get a secondary opinion of a specialist'. The most common referral problem was 'gastrointestinal'. 'Internal medicine' was the most frequently consulted specialty.
Chungcheongnam-do* ; Family Practice ; History, Modern 1601- ; Humans ; Korea ; Office Visits ; Referral and Consultation* ; Specialization ; Tertiary Care Centers ; Surveys and Questionnaires

BACKGROUND: Consultation and referral are important characteristics of modern medicine which has become more segmented and more specialized. In particular, they give essential value to family practitioners to coordinate patients accordingly for proper care. This study analyzed the referred patients in family practices under Cheonan practice based-research network (CPBRN). METHODS: The data was collected via questionnaire in ten family clinics under CPBRN system during the four weeks from June 15, 2006 to July 12, 2006. RESULTS: The total number of referred cases was 103 (0.7%) out of a total of 14,466 office visits. Among the total, 68.9% of referred cases was physician-drived and 31.1% was patient-requested. The reason for referral were 'to get a second opinion of specialist' (34), 'high severity' (20), 'lack of examination tool' (18), 'lack of skill' (10) and 'no response to treatment' (2) in physician-drived cases, whereas in patient-requested cases, they were 'request for advanced hospital' (26) and 'want to meet specialist' (2). The patients were referred to tertiary hospital in 66.7%, secondary hospital in 15.9%, and other specialists of primary setting in 10.1%. Overall, 66.7% of the referred hospital was located in the city area. The main health problems of referred patients was divided into 'gastrointestinal' (17.5%), 'musculoskeletal' (13.6%), 'dermatology' (10.7%) and so on. The speciality consulting physicians were 'internal medicine' (34%), 'pediatrics' (13.6%), and 'orthopedic surgery' (10.7%) specialists. CONCLUSION: The referral rate of family practice in Korea was 0.7%. The main reason for referral was 'to get a secondary opinion of a specialist'. The most common referral problem was 'gastrointestinal'. 'Internal medicine' was the most frequently consulted specialty.
Chungcheongnam-do* ; Family Practice ; History, Modern 1601- ; Humans ; Korea ; Office Visits ; Referral and Consultation* ; Specialization ; Tertiary Care Centers ; Surveys and Questionnaires

OBJECTIVE: To evaluate pathological complete remission rate (pCR), survival rate, recurrence rate, 91 patients who had clinical complete remission with epithelial ovarian cancer were studied. METHODS: From 1983 to 2002, 91 consecutive patients with epithelial ovarian cancer underwent surgical cytoreduction followed by platinum-based chemotherapy at the Department of Obstetrics and Gynecology, Hanyang University Hospital. At the conclusion of chemotherapy, all patients who were clinically disease free and whose CA 125 was < 35 were offered a second-look operation that obtained over 20 specimens. Of 91 patients who qualified for second-look, 57 underwent the procedure and 34 did not undergo the laparotomy. RESULTS: Among 57 patients who had been performed second-look laparotomy, 40 patients (70%) had negative pathology, 9 (16%) were microscopically positive, and 8 (14%) had gross disease. Patients with positive findings received individualized salvage therapy (14/17). FIGO stage (p<0.01), initial CA 125 level (p=0.07) and residual tumor at primary surgery (p=0.01) correlated with second-look results. Eight (20%: 8/40) of the patients with negative pathology have recurred. Five year survival rate was 95% in patients refusing second look (n=34) was similar to 77% in patients who had been performed second-look operation (n=57). Five-year and ten-year survival rates were 77% and 68% in patients who had performed second-look laparotomy. And 5-year and 10-year survival rates were 84%, 84% in 40 patients with negative pathology, however, 53%, 34% of 17 patients with positive result. Stepwise logistic regression selected two covariates significantly affecting survival: the stage and residual tumor. CONCLUSION: Using the protocol described in a population of optimally resected patients with advanced stage ovarian cancer, second-look laparotomy can impact positively on survival. Patients with residual tumor > 2 cm with advanced stage at primary surgery and negative second-look findings should be the focus of future protocols for consolidation chemotherapy.
Consolidation Chemotherapy ; Drug Therapy ; Gynecology ; Humans ; Laparotomy* ; Logistic Models ; Neoplasm, Residual ; Obstetrics ; Ovarian Neoplasms* ; Pathology ; Recurrence ; Salvage Therapy ; Survival Rate

BACKGROUND: Obesity is a risk factor of hyperlipidemia, DM, hypertension and cardiovascular diseases. In clinical practice the evaluation of obesity has been done indirectly by anthropomet ric indices such as BMI, waist to hip ratio, waist and hip circumference. This study was attempted to show whether waist circumference is better simple anthropometric index of abdominal obesity and has better correlation of metabolic profile than waist to hip ratio which has been commonly used. METHODS: We gathered 286 cases who have undergone medical examination from May 1997 to July 1997 at Dankook University Hospital and measured BMI, relative ideal body weight by Modified Broca method, waist circumference, waist to hip ratio, metabolic profiles, fasting blood sugar, systolic and diastolic blood pressure. RESULTS: Waist to hip ratio and waist circumference showed high correlation with BMI and Modified Broca index. In men, correlation coefficient of waist circumference and waist to hip ratio with BMI was r=0.761, r=0.467, and correlation coefficient of waist circumference and waist to hip ratio with Modified Broca index was r=0.726, r=0.458. In women, correlation coefficient of waist circumference and waist to hip ratio with BMI was r=0.791, r=0.628, and correlation coeffience of waist circumference and waist to hip ratio with Modified Broca index was r=0.769 r=0.660. This finding showed waist to hip ratio and waist circumference is more closely related to BMI and Modified Broca index in women than men and showed higher correlation with waist circumference than waist to hip ratio. There were significant differences of correlation coefficient of obesity indices between waist circumference and waist to hip ratio (p<0.00001). Waist circumference showed relatively significant correlation with metabolic profiles, but we could not observe high correlation coefficient. But there was significant difference of distribution between normal group and obese group defined as BMI>25 and modified Broca index>120%. CONCLUSION: Waist circumference, index of abdominal obesity has better correlation with obesity indices than waist to hip ratio and is a simpler method.
Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Fasting ; Female ; Hip ; Humans ; Hyperlipidemias ; Hypertension ; Ideal Body Weight ; Male ; Metabolome ; Obesity ; Obesity, Abdominal* ; Risk Factors ; Waist Circumference* ; Waist-Hip Ratio

Teaching both English in medical field and bioethics to medical students in Korea is becoming more and more important. We have investigated the present status of medical English and bioethics lectures in medical schools in Korea. We have taught bioethics in medical English class and investigated its effect through questionnaire. Less than two thirds of the 35 medical schools in Korea have medical English and /or bioethics lectures. Mainly English medical terms were taught in premedical course in most of the school which needs to be improved. Evaluation of the bioethics lecture in medical English class was responded favorably by the students. In conclusion, teaching bioethics in medical English class in English appears to be an effective way of teaching both English and bioethics in medical field at the same time and a good way of saving time by teaching both simultaneously.
Bioethics* ; Humans ; Korea ; Lectures ; Schools, Medical ; Students, Medical ; Surveys and Questionnaires

BACKGROUND: The quality of specimen for Papanicolaou smear depends on the sampling methods of uterine cervix. This study was designed to test specimen adequacy and the detection of disease using t,wo cervical cytological sampling methods. pastic spatula plus Cytobrish and Cervex-Brush. METHODS: Research subjects were t.he exarninee for screening for cevical cancer in Farnily Practice Center and Health Promotion Center of University Hospital. Research sub jects were classified to two groups randomly. 5 physicians used each device at random. A group 80 test smples(plast,ic spatula plus Cytobrush) were compared with B group test samples(Cervex Brush) for the presence rate of endocervial cells and specimen adequacy. The laborat.ory was blind to the sampling met,hods. RESULTS: The plastic spatula plus Cytobrush and Cervex-Brush were comparable in cap- turing in endocervical cells. But the capturing rates of both methods were high(over 70%). Both the pastic spatula plus Cytobrush and Cervex-Brush produced adequate samples, and the adequacy scores between two methods were not different. significantly. CONCLUSIONS: Use of the plastic spatula puls Cytobrush and Cervex-Brush produced adequate smear for interpretation.
Cervix Uteri ; Female ; Health Promotion ; Humans ; Mass Screening ; Papanicolaou Test ; Plastics ; Research Subjects