Background
: Although it has become obvious that male osteoporosis represent a public health issue, few studies has been done in Korea concerning the association between grip strength and bone mineral density(BMD) in men. This study was undertaken to enforce the necessity of muscle strengthening exercise program to improve BMD in middle-aged men by evaluate the association between grip strength and BMD.

Methods : The study was performed from January to December 1998 in the health screening center of CHA hospital with 174 men who measured both BMD and grip strength. BMD was measured at the proximal and distal radius of the dominant hand using Osteoplan p-DXA and grip strength was measured from the dominant hand using dynamometer. Daily calcium intake was measured through the interview with the diet therapist. Other datas were obtained from the questionnaire.

Results : We found a significant positive correlation between grip strength and BMD of distal and proximal radius(r=0.208; P<0.01, r=0.2555; P<0.01) and a significant negative correlation between age and BMD of distal and proximal radius(r=-0.313; P<0.01,r=-0.190; P<0.05). There was no correlation between calcium intake and BMD. BMI was correlated significantly only with BMD of distal Radius(r=0.194; P<0.05). There was no significant difference in BMD either by smoking or exercise. The multiple regression analysis showed that grip strength was independently correlated with BMD of the proximal radius significantly(β=1.731, P<0.05), but not with BMD of the distal radius after adjusting the confounding variables.

Conclusion : In conclusion, there is a significant correlation between grip strength and BMD in middle aged men. Therefore it can be safely concluded that it is helpful to carry out muscle strengthening program to improve muscle strength and increase BMD for preventing male osteoporosis.

Background
: The prevalance of coronary heat disease is significantly higher in men than in premenopausal women of the same age. Impact that endogenous androgens have on serum lipid has many arguments and few researches were made in Korea. So this study was made to investigate correlation between total testosterone and serum lipid known as effect on cardiovascular disease.

Methods : This was a cross-sectional study on 560 middle aged men undertaken health screening program in Pundang General Hospital. Korea for June 1999 to June 2000. We surveyed informations concerning exercise, consumption of alcohol and smoking by means of self questionnaire records and total testosterone and serum lipid were measured at fasting state.

Results : Body mass index was positively correlated with total cholesterol and triglycerides(r=2.023;P<0.01, r=0.229;P<0.01) but negatively correlated with HDL-cholesterol (r=-0.284;P<0.001). Total testosterone concentrations were negatively correlated with total cholesterol and triglyceride(r=-0.096; P<0.05, r=-0.145; P<0.01) but positively correlated with HDL-cholesterol(r=0.155; P<0.001). Total testosterone concentrations were independently correlated with HDL-cholesterol after age and body mass index were adjusted(B=0.734; P<0.05). And after statistical adjustment for age, body mass index, exercise, smoking and alcohol, total, testosterone concentrations were significantly correlated with triglyceride(B=-10.467; P<0.05).

Conclusion : The result indicate that total testosterone can be a independent determinant of HDL-cholesterol and we expect that appropriate maintenance of total tetosterone concentrations will have a protective effect for cardiovascular disease.

Background
: The cognitive subscale of the Alzheimer's Disease Assessment Scale(ADAS-Cog) has been extensively validated in assessing cognitive function in patients with Alzheimer's Disease (AD) and used as an efficacy measure in clinical trials of AD. There is a need for additional data on the relationship between cognitive performance and other measures of dementia to fully assess the value of the ADAS-Cog as a measure of treatment efficacy.

Methods : We used data from 53 AD participants in 8 multicenter clinical drug trials to examine the distribution of baseline ADAS-Cog scores in relation to Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDES), Katz Index of Activity of Daily Living(ADL), Lawton Instrumental Activity of Daily Living(IADL), Geriatric Depression Scale(GDS) and Mini-Nutritional Assessment(MNA).

Results : The ADAS-Cog score was statistically significantly correlated with MMSE (T=-0.755, P<0.001), GDES(R=0.403, P<0.003), ADL(R=-0.532, P<0.001), IADL(R=-0.626, P<0.001) and MNA(R=-0.427, P=0.004) scores. But GDS scores were not associated with ADAS-Cog scores.(R= -0.123, P=0.396)

Conclusion : This study characterizes the relationship between ADAS-Cog scores and other commonly used measures of dementia in AD patients. As expected, baseline scores on ADAS-Cog and MMSE demonstrated significantly high correlation. The relatively weaker correlation between ADAS-Cog and GDES scores may be related to the fact that GDES does not evaluate cognitive function only. There are also significant correlations between ADAS-Cog and ADL, IADL, and MNA which indicate the severity and progression of dementia in AD patients. Further studies with larger samples including cognitive function of broader spectrum need to confirm the findings in this study.

Background
: Several studies have reported that muscle strength and bone mineral density have a significant positive correlation and most previous literature on muscle strength and bone mineral density examined their association. To evaluate the association between grip strength and radius bone mineral density, more precise PQCT was used rather than SPA or DEXA.

Methods : The study was performed from June to August 1999 in Pundang community with 154 postmenopausal women who undertaken osteoporosis screening program who participated in this study. Bone mineral density was measured at the radius using PQCT (peripheral quantitive computed tomography). Grip and pinch strength were measured in both the dominate and nondominant hand using a dyanometer. Other data were obtained from the questionnaire.

Results : Grip and pinch strength of the dominant hands were significantly higher than the nondominant hands. There was no significant difference in bone mineral density by exercise and fracture history. Age-adjusted partial correlation analysis indicated a significant positive correlation of radius BMD with dominant hands grip strength. Significant positive correlations also were found between radius BMD and pinch strength.

Conclusion : Subjects with stronger grip strength had a low BMD. There was a significant positive correlationship between bone mineral density and dominant hand grip strength. The data suggest that grip strength is a weak predictor of radius bone mineral density and provide a feasible way of predicting it.

Background
: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant de-spite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalence of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms.

Methods : The subjects were 409 people who underwent esophagogastroduodenoscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characteristics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking, alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were analyzed by Chisquare test.

Results : CLO test was positive for 264(64.5%) in total, 156(65.3%) in males, 108(63.5%) in females, not different significantly in each group. The frequency of CLO test positive was 53.3%(under 30 years old), 64%(thirties), 66.9%(forties), 67.9%(fifties), 48%(over 60 years old). H. pylori infection increased slightly as age increased, but decreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alcohol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively.

Conclusion : The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection was not significant biostatistically.

Background
: With the rapid increase in the number of the aged population, curable or controlled diseases were treated as aging process because of the difficulty of early detection and treatment of disease and specificity of elderly patients. We help manage elderly patients by studying their frequency of common known disease and hidden disease that would enable the curable diseases to be detected early, and noncurable disease to be controlled.

Methods : The subjects included 128 patients over 60 years old who had completed structured questionnaires and we reviewed chart records among 208 patients registered from January 1997 to July at the Health Screening Center of a general hospital in Kyonggi-do. Known diseases were based on charts recorded through structured questionnaires and hidden diseases were based on health screening results and overall geriatric assessment data.

Results : The number of patients was 128 in which male was 47 and female was 81. The ratio between male and female was 1:1.72 and the average age was 66.0 years. In the order of frequency, the most common known diseases were hypertension, arthritis, G-I disturbance, diabetes mellitus, chronic obstructive pulmonary disease, heart disease, depression and the hidden diseases they were arthritis, G-I disease, depressive mood, malnutrition, hypertension, osteoporosis, hearing loss, hypercholesterolemia, hypomagnesemia, incontinence, anemia, decreased cognitive function.

Conclusion : We assessed the characteristics of multiple pathology in geriatric patients and realized that it was important to manage aggressively those with a hidden disease that can be treatable after early detection through overall geriatric assessement.

Background
: It was known that physical illness and depression due to cognitive function defects increase in the elderly. This study was designed to evaluate the prevalence of depressive mood, associated factors and to help understanding recent trends of the depressive elderly.

Methods : We selected 108 subjects over 65-year-old who visited Health Promotion Center, Pundang CHA General Hospital for geriatric health evaluation from Mar. 1996 to Feb. 1997. We analyzed Geriatric Evaluation Record to know the effect of sociodemographic factors, life styles and geriatric medical factors by Geriatric Depression Scale(GDS).

Results : The result showed that depressive mood appeared 20(37.0%) in male, 35(64.8%) in female and 55(50.9%) in total among 108 subjects. Factors associated with deprssive mood of the elderly were occupation(p<0.05), regular exercise(p<0.001), nutritional status(p<0.05), functional status and alcohol drinking.

Conclusion : The prevalence of depressive mood of the elderly was 50.9%, and the depressive mood have been affected more for the elderly who was out of work, not doing regular exercises and got high nutritional risk. Further study is required to know other factors influencing on depressive mood of the elderly.

Background
: Falls and their consequences occur at all stages of life, but they occur much more commonly in old age and the elderly are more prone to injury themselves. Hip fracture is one of the most common and severe complications from falls. Furthermore, it is the leading cause of morbidity and mortality in the elderly. In this paper, we reviewed the charts and tried to find the characteristics of falls as a cause of hip fracture and risk factors in the elderly.

Methods : Charts were reviewed. The patients that admitted from January 1990 to July 1993 had all hip fractures and they were all above 65 years. The situations, place(mainly environmental factors), age, sex, BMI(body mass index), kinds of injury and existed intrinsic factors were reviewed.

Results : Total numbers were 202 cases, the fractures by falls were 161(79%). As ages increased, cases increased too. BMI was relatively low. (mean ; men 20.9, women 20.0) Femur neck fractures were developed relatively high than intertrochanteric fractures, environmental factors were involved in falls apparantly(94 cases, 62%). The places were restroom(22 cases), stairs(21 cases), roads(14 cases), room(12 cases), floors(0 cases), icy or snowy ways and so on. Intrinsic factors of falls were lower limb dysfunction(23 cases, 14.3%), visual disturbance(13 cases, 8.1%), past history of stroke(18 cases, 11.2%), Parkinson's disease(2 cases), and drugs including alcohol (2 cases). The number of intrinsic risk factors per one person was 0.44. Another risk factors were vertebral abnormalities and osteoporosis(11.3 cases, 6.8%) and chronic diseases(20 cases 12.4%).

Conclusion : Most of hip fractures were developed by falls. Falls were complex processes including environmental and intrinsic risk factors. Most of the elderly need the caution of falls and espesially the olds that have intrinsic risk factors should be encouraged to prevent falls practically and they need practical preventive methods. All doctors that care of the elderly should recommend preventive protocols to them.