Background : In evaluation and managing obese patients, it is more important to assess obesity itself as well as the associated disease than to focusing on reduction of body weight alone. Our study was carried out to identify the characteristics of hypertension and hyperlipidemia.
Methods : We selected obese adult patients over twenty who visited the obesity clinic at Asan Medical Center. Questionnaire was given on medical history, eating behavior, food frequency, activity degree and so on. we collected the 233 data of questionnaire and medical records, and analysed the characteristics of hypertension, hyperlipidemia.
Results : The frequency of hypertension and hyperlipidemia was higher in men than women. but that of binge eating was higher in women than men. For men, waist circumference was significantly higher in hypertensive group with 108.9±12.7cm than normotensive group with 101.2±9.1cm (p<0.05). For women, there were trends for increased frequency of hypertension and hyperlipidemia with age, and decreased frequency of binge eating with age (p<0.05). The BMI was significantly higher in female hypertensive group with 30.8±5.4kg/㎡ than in normotensive group with 29.4±3.2kg/㎡ after adjusting for age.
Conclusion : The accompanying health problems with obesity depend on gender, age, distribution of adiposity and nutritional intake. In evaluating obese patients, it should be stressed to assess co-morbidity and associated factors, and to manage comprehensively.
Background : Fatigue is a common complaint of the middle-aged male. Some studies show that fatigue is associated with depression, anxiety, or stress and caused by physical or psychological factors. The impact of these factors with fatigue severity is not, known. The purpose of this study was to evaluate the association of above factors with fatigue severity in middle-aged male workers.
Methods : The subjects were middle-aged male workers seen for health check up at a university hospital in Pusan from Sep. 1998 to Dec. 1998. Subjects completed questionnaire about fatigue severity, fatigue type, depression, anxiety, stress and activity level. Subjects were divided into 4 groups in the order of fatigue severity ; No Fatigue Group, Fatigue Group I , Fatigue Group II, Fatigue Group III.
Results : Among 218 subjects, 90 (41.3%) were No fatigue Group, 44 (20.2%) were Fatigue Group I, 50 (22.9%) were Fatigue Group II, and 34 (15.6%) were Fatigue Group III. Fatigue severity was significantly different between the 5th and 6th decade age groups(P=0.018). As fatigue severity was increased, depression, anxiety, and stress were increased, but activity level was decreased (P<0.01). Depression, anxiety, stress and activity level were significantly different between No Fatigue Group and Fatigue Group III. Depression, anxiety and stress were significantly different by fatigue severity. fatigue severity had a positive correlation with total fatigue, physical fatigue, psychological fatigue, depression, anxiety, and stress, but a negative correlation with activity level(P<0.01).
Conclusion : Fatigue is common among middle-age male workers. Fatigue severitys was associated with an increase in depression, anxiety, and stress, but was decreased with activity level. The influence of physical fatigue was in proportion to fatigue severity. Therefore, understanding fatigue as a continuous variable may be useful in patient care.
Background : Prevalence studies on chronic fatigue and Chronic Fatigue Syndrome (CFS) in the Western countries exist since the 1980's, but are very rare in Korea. To investigate the prevalence of chronic fatigue and CFS, we conducted this study.
Methods : The study subjects were 988 consecutive patients with medical problems who visited a primary care practice in a tertiary hospital. The subjects were asked on the chronic fatigue related primary questions. Among the subjects, the chronic fatigue patients were aske on chronic fatigue related secondary questions and further evaluation was done. The chronic fatigue subjects were classified to explained and unexplained chronic fatigue group. The unexplained chronic fatigue group was reclassified to CFS-like illness and idiopathic chronic fatigue (ICF) like illness according to CFS diagnostic criteria (Fukuda etc., 1994).
Results : Among 988 study subjects, the prevalence of chronic fatigue patients were 113 (11.44%). Explained and unexplained chronic fatigue patients were 84 (8.51%), 29 (2.94%), respectively, and socioepidemiologic and chronic fatigue related characteristics between two groups were similar. The findings indicated the prevalence of CFS-like illness and ICF-like illness were 1.22% and 1.72%, respectively.
Conclusion : Chronic fatigue was a common symptom and CFS-like illness was not rare in a primary care practice.
Background : Fasting blood sugar and urine glucose are measured as screening tests of diabetes in the workers' periodic health examination. but of the casual glucose is measured and the basis of the cut-off values of screening tests is not clear. Therefore, we investigated the accuracy of screening test of diabetes in periodic health examination.
Methods : One hundred and eighty two men were selected for this study in 1997-1998. They performed a second confirmatory test for diabetes because their initial screening test results showed 'suspicious diabetes'. The gold standard was a fasting blood glucose for the second test. We analyzed the sensitivity and the specificity of each cut-off values of initial fasting blood glucose and urine glucose, and constructed the receiver operator characteristic (ROC) curve.
Results : The correlation coefficient between initial blood glucose and second fasting glucose was 0.562, and that between initial glucose and 2nd post-prandial glucose was 0.551. The false positive rate of initial screening test was 62.1%. When the cut-off value of initial blood glucose was 144.98mg/dl, the sensitivity was 0.79 and the specificity was 0.97. Using the current cut-off value of 121 mg/dl, the sensitivity was 0.11 and the specificity was 1.0. The best cut-off value of urine glucose test was trace on the basis of ROC curve.
Conclusion : The problem of diabetic screening test was high false positive rate and the low correlation coefficient between screening test and the gold standard. It is necessary to control the test condition and to reset cut-off value up, to make the screening test accurate.
Background : All individuals chronically positive for HBsAg are not always complicated by advanced liver diseases and have various differences in their clinical progression. In an attempt to find out the factors determining clinical progression, comparative analysis was made among four groups (asymptomatic, chronic hepatitis, liver cirrhosis and hepatocellular group) according to the titers of HBeAg and HBeAg, and the presence or absence of HBeAg and HBV-DNA.
Methods : This study included 198 males and 96 females who visited Asan foundation Kangnung Hospital from Sep. 1, 1996 to May 31, 1998 and the subjects were HBsAg-positive for at least six months. They were classified into four groups on the basis of their worst results after CBC, LFT, and abdominal ultrasonography carried out on two occasions at least at three-month intervals. For confirmation of hepatoma abdominal CT and hepatic angiography were performed. Among the four groups compared were the mean titers of HBsAg and HBeAg, and positive rate of HBeAg and HBV-DNA.
Results : A total of 294 subjects was diagnosed as having no symptoms in 169(57%), chronic hepatitis in 71 (24.1%), liver cirrhosis in 41 (13.9%), and hepatoma in 13 subjects (4.4%). The more advanced in age (p<0.01) and sexual preference of males (p<0.05) were found to be associated with worse liver conditions. The Asymptomatic Group showed lower titers of HBsAg (p<0.01) and HBV-DNA (p<0.01). In the case of subjects without HBeAg, the presence of HBV-DNA was significantly linked to chronic hepatitis and liver cirrhosis (p<0.01). Based on age by multiple regression, the group of less than 29 years of age had higher titer of HBeAg as determinant factor for clinical progression, 30-39 years of age the presence of HBV-DNA, 40-49 years of age the presence of HBeAg, the presence of HBeAg and male, the group of more than 50 years of age had higher titers of HBeAg, the presence of HBV-DNA, and higher titers of HBsAg.
Conclusion : The present study revealed that clinical progression depended upon the titers of HBsAg and HBeAg, and the presence or absence of HBeAg and HBV-NDA in the same age group, and sexual preference for males as well as older age counted for clinical worsening of chronic HBsAg-positive subjects.
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