Implementation of a Videoconferencing System between Multiple Family Medicine Departments

Lee, Kee Hyuck,Kim, Ju Young,Lee, Kiheon,Cho, Belong,Yang, Jeong Hee,Goh, Eurah,Bae, Woo Kyung The Korean Academy of Family Medicine 2011 Korean Journal of Family Medicine Vol.32 No.5

<P>Attending conferences is important for doctors and residents in family medicine. Nevertheless, departments of family medicine at many hospitals find it difficult to hold regular conferences. Holding joint videoconferences between Family Medicine Departments of several hospitals through a videoconferencing system could solve this problem. Therefore, Family Medicine Departments of Seoul National University Hospital, Seoul National University Bundang Hospital, and Kangwon National University Hospital decided to hold regular joint videoconferences via a videoconferencing system. Eighty-one joint videoconferences were held from April 1 to October 29, 2010. PowerPoint slideshows were transferred to the other two locations in the same resolution as presenter's monitor. Image and voice of the speaker were transferred in real time and in acceptable quality. Joint videoconferences are feasible, satisfactory and useful for medical education, especially when individual family medicine departments are small and lack resources to hold face-to-face conferences. We expect that more family medicine departments will choose to participate in implementing similar joint videoconferencing systems in the future.</P>

Factors Associated with the Use of Uterine Cervical Cancer Screening Services in Korean Elderly Women

Ko, Ki Dong,Park, Sang Min,Lee, Kiheon The Korean Academy of Family Medicine 2012 Korean Journal of Family Medicine Vol.33 No.3

<P><B>Background</B></P><P>The Papanicolaou (Pap) smear test is an effective screening test for the early detection of uterine cervical cancer. The Pap test still plays an important role in Korean elderly women, as uterine cervical cancer remains a frequent form of cancer and an important cause of death. However, the participation rate and other factors related to the Pap test in Korean elderly women have been studied insufficiently.</P><P><B>Methods</B></P><P>This study included 654 individuals aged 65 and over who completed a cervical cancer screening questionnaire from the Third Korean National Health and Nutrition Examination Survey 2005. Using multiple logistic regression, odds ratios and confidence intervals for the association between attendance of the Pap test and sociodemographic or health-related factors were calculated.</P><P><B>Results</B></P><P>One hundred and eleven individuals (17.0%) of the study population showed compliance with Pap testing within the previous 2 years. We recognized that the most elderly women (75 years and over) or those with lower levels of education were less likely to have had the test.</P><P><B>Conclusion</B></P><P>Primary health care providers need to make efforts to improve attendance rates of Pap smear screening in Korean elderly women, individually taking into account previous Pap results, life expectancy, risk factors for cervical cancer, and preferences. More attention will especially be needed among the eldest elderly or less educated elderly women.</P>

Factors Related to Body Mass Index and Body Mass Index Change in Korean Children: Preliminary Results from the Obesity and Metabolic Disorders Cohort in Childhood

Lee, Hyun Hye,Park, Hyun Ah,Kang, Jae Heon,Cho, Young Gyu,Park, Jin Kyun,Lee, Ran,Yoon, Ji Ye,Kim, Ok Hyun The Korean Academy of Family Medicine 2012 Korean Journal of Family Medicine Vol.33 No.3

<P><B>Background</B></P><P>This preliminary study is to assess risk factors associated with children's body mass index (BMI) and their changes over a 2-year period based on the analysis of the Obesity and Metabolic Disorders Cohort in Childhood registry.</P><P><B>Methods</B></P><P>A total of 1,504 children comprised of 474 1st graders and 1,030 4th graders were included in the study. Data on physical activity, dietary intake, and socioeconomic status were obtained through self-administered questionnaires, and height and weight were measured annually for 2 years.</P><P><B>Results</B></P><P>In a cross-sectional analysis, BMI of 1st graders was associated with higher parental BMI (both P < 0.001) and frequent snack consumption (P = 0.049). BMI of 4th graders was additionally associated with shorter sleep duration (P = 0.001), lower household income (P = 0.016), higher fat intake (P = 0.017), and frequent meal skipping (P = 0.020). During a 2-year follow-up, BMI increased by 0.8 ± 1.4 kg/m<SUP>2</SUP> in 1st graders and by 1.3 ± 1.4 kg/m<SUP>2</SUP> in 4th graders. In a longitudinal analysis, higher exercise frequency (P = 0.007), shorter sleep duration (P = 0.027), lower household income (P = 0.002), and higher paternal BMI (P = 0.002, 0.043) were significant predictors of BMI changes in the 1st graders whereas only higher maternal BMI (P=0.035), and frequent snack consumption (P = 0.010) were predictors for the 4th graders BMI changes.</P><P><B>Conclusion</B></P><P>Our findings indicate that parental obesity, short sleep duration, low socioeconomic status, and frequent snacking are associated with BMI and BMI changes.</P>

Urine Cotinine and Environmental Tobacco Exposure in Korean Adolescents

The Korean Academy of Family Medicine (KAMJE) 2009 Korean Journal of Family Medicine Vol.30 No.3

Association of Heart Rate Variability with the Framingham Risk Score in Healthy Adults

Yoo, Cheol Seung,Lee, Kayoung,Yi, Sang Hoon,Kim, Jun-Su,Kim, Hee-Cheol The Korean Academy of Family Medicine 2011 Korean Journal of Family Medicine Vol.32 No.6

<P><B>Background</B></P><P>The aim of this study was to investigate the relationship between heart rate variability (HRV), the Framingham risk score (FRS), and the 10-year risk of coronary heart disease (CHD) development among Korean adults.</P><P><B>Methods</B></P><P>The subjects were 85 healthy Korean adults recruited from a health check-up center. The FRS and 10-year risk of CHD development were calculated.</P><P><B>Results</B></P><P>The FRS in men was inversely correlated with the standard deviation of all normal to normal RR-intervals (SDNN); the root mean square successive difference (RMSSD); the percentage of successive normal cardiac inter-beat intervals greater than 20 ms, 30 ms, and 50 ms (pNN20, pNN30, pNN50); the low frequency (LF); and the high frequency (HF) (P < 0.05). There was no significant relationship between the FRS and HRV in women. Overall, in the receiver operating characteristic (ROC) analysis, the RMSSD, HF, SDNN, LF, LF/HF ratio, and pNN30 predicted an increased 10-year CHD risk. After adjusting for sex and body mass index, those with greater than one standard deviation in the RMSSD, HF, and LF had a 52-59% reduction in their 10-year risk of CHD development ≥ 10%.</P><P><B>Conclusion</B></P><P>This study therefore indicates that the HRV indices, particularly SDNN, RMSSD, pNN30, LF, and HF may be useful parameters for the assessment of CHD risk. Most notably, the usefulness of these HRV measures as indicators for CHD risk evaluation may be greater among men than among women.</P>

A Case of Scrub Typhus Complicated by Acute Calculous Cholecystitis

Lee, Su Jin,Cho, Young Hye,Lee, Sang Yeoup,Jeong, Dong Wook,Choi, Eun Jung,Kim, Yun Jin,Lee, Jeong Gyu,Lee, Yu Hyun The Korean Academy of Family Medicine 2012 Korean Journal of Family Medicine Vol.33 No.4

<P>We report a case of acute calculous cholecystitis through scrub typhus. A 69-year-old woman presented with a history of general myalgia, fever, and right abdominal pain. She referred to our hospital for surgical treatment of clinically suspected acute cholecystitis. Physicians concluded the cause of cholecystitis as gall bladder (GB) stone and proper antibiotics treatment of scrub typhus was started later. The patient developed acute respiratory distress syndrome and multi organ failure through scrub typhus. Five days after admission, the patient was treated with proper antibiotics and discharged on the 13th day after starting doxycycline treatment without any sequelae. In areas endemic for tsutsugamushi disease, even though a patient with GB stone presents with symptoms of acute cholecystitis, careful history and physical examination are required to reveal the existence of eschars or skin eruptions.</P>

The Prevalence of Chronic Diseases among Migrants in Korea According to Their Length of Stay and Residential Status

Lee, Choong-Hyung,Yun, Jae-Moon,Han, Jong-Soo,Park, Sang-Min,Park, Young-Su,Hong, Seung-Kwon The Korean Academy of Family Medicine 2012 Korean Journal of Family Medicine Vol.33 No.1

<P><B>Background</B></P><P>Migrant health is becoming public health issues, as the migrant populations are increasing and their length of stay is prolonged. This study aims to analyze the differences in prevalence of chronic diseases among migrants according to length of stay and residential status.</P><P><B>Methods</B></P><P>An initial population pool were 3,024 who were assessed with health screening programs by Migrant Health Association. 2,459 migrants were selected for final analysis. Via Stata 10 we conducted univariate logistic regression analysis to examine the effects of their length of stay and residential status on the prevalence of hypertension, diabetes, dyslipidemia, and obesity. In the final analysis, the result of each sex was adjusted for age, nationality, length of stay, and residential status via multiple logistic regression analysis.</P><P><B>Results</B></P><P>Longer length of stay tends to increase the prevalence of hypertension in male; 4-6 year stay-duration group demonstrated statistically significant excess compared to 1 year or less stay-duration group (adjusted odds ratio [OR], 1.39; confidence interval [CI], 1.01 to 1.92). After adjustment, male migrants stayed more than 7 year showed considerably higher dyslipidemia than male migrants stayed less than 1 year (adjusted OR, 1.95; CI, 1.05 to 3.64). Compared to the group with 1 year or less stay-duration, the prevalence of obesity in male was significantly higher among 4-6 year (adjusted OR, 1.65; CI, 1.17 to 2.32) and 7 year or more stay-duration group (adjusted OR, 1.65; CI, 1.11 to 2.45).</P><P><B>Conclusion</B></P><P>Longer length of stay correlated to higher prevalence of hypertension, dyslipidemia, and obesity among some population of migrants. So more researches and new developing policies are needed for this problem.</P>

Adiponectin in Women with Polycystic Ovary Syndrome

Shin, Hyun-Young,Lee, Duk-Chul,Lee, Ji-Won The Korean Academy of Family Medicine 2011 Korean Journal of Family Medicine Vol.32 No.4

<P><B>Background</B></P><P>Though adiponectin has been associated with insulin resistance and cardiovascular risk factors, the relationship between adiponectin and polycystic ovary syndrome (PCOS) remains controversial. The aim of this study was to compare adiponectin level in women with PCOS and without PCOS, and to investigate the relationship between adiponectin level and metabolic variables including insulin resistance.</P><P><B>Methods</B></P><P>60 women with PCOS were enrolled along with a control group of 80 healthy women, matched for age and body mass index (BMI). We measured hormonal and metabolic parameters, as well as the plasma adiponectin concentration of each participant. We estimated the insulin sensitivity according to the quantitative insulin sensitivity check index (QUICKI).</P><P><B>Results</B></P><P>The PCOS group displayed significantly lower level of adiponectin (P < 0.001) after adjustment for age, BMI, mean blood pressure, fasting glucose, fasting insulin, and several metabolic parameters. Adiponectin levels were positively correlated with QUICKI in the PCOS group (P < 0.001) and the control group (P = 0.03). Following step-wise multiple regression analysis, however, adiponectin level was positively correlated with QUICKI in the control group only (P = 0.03). In addition, adiponectin level was found to be independently associated with HDL-cholesterol level (P < 0.001) and BMI (P = 0.02) in the PCOS group and independently associated with HDL-cholesterol (P = 0.02) in the control group.</P><P><B>Conclusion</B></P><P>We report decreased adiponectin level in PCOS patients in relation to controls independently of insulin resistance or other metabolic factors. And adiponectin is associated with both lipid metabolism and obesity, which, in turn, is related to insulin resistance in PCOS. Further studies are needed to clarify the mechanism of adiponectin in PCOS.</P>

Changes in Skin Color after Smoking Cessation

Cho, Young Hye,Jeong, Dong Wook,Seo, Sang Hee,Lee, Sang Yeoup,Choi, Eun Jung,Kim, Yun Jin,Lee, Jeong Gyu,Lee, Yu-Hyun,Bae, Mi Jin,Chin, Hyun Woo The Korean Academy of Family Medicine 2012 Korean Journal of Family Medicine Vol.33 No.2

<P>This study was performed to assess changes in skin color over 1 month after smoking cessation. The study population consisted of 49 men who participated in a smoking cessation program from March 2010 to June 2010 at a public health centre in Yangsan, South Korea. Thirty-four men who stop smoking completely were included in our study. Instrumental evaluations of skin color were performed using Mexameter (MX 18; Courage and Khazaka Electronic GmbH) at the beginning of the study and at 1-week and 4-week follow-up visits. Skin color was evaluated by measurement of 2 main color bases-melanin and haemoglobin-with the results expressed as melanin index (MI) and erythema index (EI). Both MI and EI were significantly reduced at the 4-week follow-up visit on all 7 sites measured. We anticipate that desirable effects on skin color after smoking cessation will play a positive role in maintaining smoking abstinence in routine clinical practice.</P>