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Association between C-Reactive Protein and Metabolic Syndrome in Korean Adults
Youhyun Song,Soo Kyung Yang,Jungeun Kim,Duk-Chul Lee 대한가정의학회 2019 Korean Journal of Family Medicine Vol.40 No.2
Background: The prevalence of metabolic syndrome (MetS) is increasing, and obesity, insulin resistance, and in-flammation are the known risk factors. However, results of previous studies regarding the relationship between MetS and inflammation have not been consistent. This study aimed to identify the associations between C-reactive protein (CRP) and MetS and its components in obese and non-obese men and women.Methods: This was a cross-sectional study based on the 6th Korea National Health and Nutrition Examination Sur-vey (2015), and a nationally representative sample of 3,013 Korean adults aged 40–78 years were included. Those with cardiovascular disease, cancer, CRP level >10 mg/L, white blood cell count >10,000/mm3, chronic kidney dis-ease, and lung/liver disease were excluded.Results: Approximately 11.0%, 50.0%, 8.4%, and 48.8% of non-obese men, obese men, non-obese women, and obese women presented with MetS (P<0.001), respectively. In all four groups, those who presented with MetS or its components showed a higher high-sensitivity (hs-CRP) average than those without. Multivariate regression analy-sis showed the increased risk of developing MetS with higher quartiles of hs-CRP level in obese (3rd and 4th quar-tiles: odds ratios [ORs], 3.87 and 2.57, respectively) and non-obese women (4th quartile: OR, 2.63). The different components also showed increased ORs in the four groups. However, no statistically significant trend in the rela-tionship was found in men.Conclusion: Low-grade inflammation may increase the risk of MetS in Korean women independent of adiposity. However, due to the cross-sectional design of the present study, further studies must be conducted to identify the causal relationship between inflammation and metabolic disorders.
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Defining Essential Topics and Procedures for Korean Family Medicine Residency Training
Youhyun Song,Jinyoung Shin,Yonghwan Kim,Jae-YongShim 대한가정의학회 2021 Korean Journal of Family Medicine Vol.42 No.6
Background: This study aims to create a comprehensive list of essential topics and procedural skills for family medicine residency training in Korea.Methods: Three e-mailed surveys were conducted. The first and second surveys were sent to all board-certified family physicians in the Korean Academy of Family Medicine (KAFM) database via e-mail. Participants were asked to rate each of the topics (117 in survey 1, 36 in survey 2) and procedures (65 in survey 1, 19 in survey 2) based on how necessary it was to teach it and personal experience of utilizing it in clinical practice. Agreement rates of the re-sponses were calculated and then sent to the 32 KAFM board members in survey 3. Opinions on potential cut-off points to divide the items into three categories and the minimum achievement requirements needed to graduate for each category were solicited.Results: Of 6,588 physicians, 256 responded to the first survey (3.89% response rate), 209 out of 6,669 to the second survey (3.13%), and 100% responded to the third survey. The final list included 153 topics and 81 procedures, which were organized into three categories: mandatory, recommended, and optional (112/38/3, 27/33/21). For each cat-egory of topics and procedures, the minimum requirement for 3-year residency training was set at 90%/60%/30% and 80%/60%/30%, respectively.Conclusion: This national survey was the first investigation to define essential topics and procedures for residency training in Korean family medicine. The lists obtained represent the opinions of Korean family physicians and are expected to aid in the improvement of family medicine training programs in the new competency-based curricu-lum.
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Cho Jaehee,Song Youhyun,이지연,Lee Daeun,Go Yunsun,Kang Hee Cheol 대한가정의학회 2021 Korean Journal of Family Medicine Vol.42 No.3
Pancytopenia represents a unique challenge for primary care doctors and its etiological causes encompass various specialties, including hematology and rheumatology. Despite the existence of effective tests such as bone marrow biopsy and immunoassays to rule out the potential causes of pancytopenia, it is often difficult to pinpoint the exact diagnosis. In this case report, we have described such a ‘gray zone’ patient, who presented with pancytopenia, neutropenia, and splenomegaly, and was being treated for fungal pneumonia before being transferred to Severance Hospital (department of family medicine). As the patient had a 10-year history of multiple, long-term hospital admissions that were having a severely debilitating impact on the quality of life, we performed a partial splenic embolization as a potential cure for the symptoms. Although this induced acute blood count recovery, it failed to prevent eventual mortality from septic shock.
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