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Volume 24(5); May 2003

Reviews

Evidence-Based Prescriptions of Functional Foods for Weight Control.
Yong Woo Park
J Korean Acad Fam Med 2003;24(5):409-415.   Published online May 10, 2003
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  • 14 Download
Shoulder Pain.
Kang Hee Cho
J Korean Acad Fam Med 2003;24(5):416-426.   Published online May 10, 2003
Shoulder is one of the most common sites of pain in outpatient clinic, and allows for almost unrestrained motion in all planes due to very unique anatomical structure. Detailed history taking and special physical examination based on basic anatomical and kinesiological knowledge are important for precise patient evaluation. Further radiographic and diagnostic laboratory test are required. Common causes of shoulder pain are adhesive capsulitis, impingement syndrome, rotator cuff tear, myofascial pain syndrome, and instability. Also cervical radiculopathy, lung, cardiac and abdominal problems should be considered as a cause of shoulder pain. Characteristics, physical examination tool, and treatment for common shoulder problems are described.
  • 1,836 View
  • 129 Download
The Pathophysiology and Prognosis of Ig A Nephropathy and Acute Post-Streptococcal Glomerulonephritis.
Jinho Shin
J Korean Acad Fam Med 2003;24(5):427-436.   Published online May 10, 2003
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  • 20 Download
Original Articles
How Many Hypertensive Patients Recognize the Name of Antihypertensive Drug That They Are Taking?.
Seung Yeon Lee, Seon Ho Min, Hong Jun Cho, Hong Geou Lee
J Korean Acad Fam Med 2003;24(5):437-443.   Published online May 10, 2003
Background
: Doctor shopping is common in Korea. Therefore, if patients are not familiar with the name of the antihypertensive drug they are taking, they may end up taking a drug that previously caused them side effects and may have to start on a new antihypertensive drug. This study was to clarify the factors related to patients' recognition of the name of their antihypertensive medications.

Methods : A questionnaire survey was done in June 2002 targeting 607 outpatients who were on antihypertensive medication seeking care at Asan Medical Center, Ulsan University Hospital and a clinic in Gyungju. Out of the 607 patients, 293 patients responded to the questionnaire.

Results : Ninety six of the 293 patients (32.8%) were able to accurately name at least one of the antihypertensive drugs they were taking. Women were more familiar with names of antihypertensive drugs than men (39.4% vs 23.6%, odds ratio [O.R], 2.69; 95% confidence interval [CI], 1.39∼5.22). The recognition of a drug was greater in subjects who had a higher education level (high school or university) compared to those with a lower education level (elementary school or less) by 4.2 fold (O.R, 4.20; CI, 1.64∼10.69). The type of concomitant drug intake was lower in subjects who could name their antihypertensive drugs than for subjects who could not (O.R, 0.78; CI, 0.63∼0.98). The patients who could name their antihypertensive drugs had both a lower mean systolic (133.2±11.6 mmHg: mean±standard deviation [S.D] vs 141.3±15.5 mmHg: mean±S.D) and diastolic blood pressure, compared to the patients who could not (84.5±7.2 mmHg: mean±S.D vs 86.8±9.5 mmHg: mean±S.D) when measured twice consecutively during a recent clinic visit.

Conclusion : The recognition of a medication was associated with patient's sex, education level and the number of concomitant drug intake. The patients, who could name the antihypertensive drugs they were taking, had a lower mean systolic and diastolic blood pressure.
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The Effect of Family Medicine Clerkship on the Preference for Family Medicine as a Career Choice in Third-year Medical Students.
Hoonki Park
J Korean Acad Fam Med 2003;24(5):444-450.   Published online May 10, 2003
Background
: Family medicine clerkship gives undergraduate medical students the opportunity to integrate knowledge and skills taught in class. Impression from clerkship experience and preceptor's role model allow medical students to consider family medicine as a career choice. This study investigated the effect of family medicine clerkship on the preference for family medicine as a career choice in third-year medical students.

Methods : From July through December of 1995, one hundred third-year medical students attended family medicine clerkship at Hanyang University Medical School (HUMS). They were divided into 20 groups of 4∼6 students. Seven half-days of clerkship teaching were provided in a private family medicine clinic and 2 half-days, in an university hospital family medicine clinic. The score of preference for family medicine was measured using the 10 cm visual analogue scale.

Results : The subjects' mean age was 24.1 years. Eighty eighty percent of students were males. The mean score of preference for family medicine as a career choice were 3.2 for pre-clerkship, 6.9 for post-clerkship, and 7.0 at the end of third-year semester exam, respectively. The group preference score was different among groups. Sex, age, hometown, parents' occupation, inhabitation type, religion, and lecture exam score were not related to the preference score. Eleven percent of students hoped to specialize in family medicine in the future. The students' main conception of family medicine were 'primary care', and 'comprehensive care', in descending order.

Conclusion : Third-year family medicine clinical clerkship improved the students' preference for family medicine as a career choice. A continuous program needs to be developed to render positive effect into the final stage of resident selection.
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Influence of HMG-CoA Reductase Inhibitors on Bone Mass in Postmenopausal Women.
Sang Yeoup Lee, Yun Jin Kim
J Korean Acad Fam Med 2003;24(5):451-455.   Published online May 10, 2003
Background
: It is controversial whether the use of HMG CoA reductase inhibitors (statins) is associated with an increased bone mineral density (BMD) in humans. The purpose of this study was to assess the influence of statins on BMD in Korean postmenopausal women.

Methods : Forty-four postmenopausal women (aged 54.3±5.8 years) were included. The statin users (n=24) were administered either simvastain, atorvastatin, pravastatin, or lovastatin. The control group (n=20) did not take statins. BMD of the spine were measured by dual-energy X-ray absorptiometry. Alkaline phosphatase (ALP) was tested as a bone marker. The data were analysed with two-sample t test and paired t-test.

Results : The mean annual spinal BMD changes of the study groups were -1.5±5.6% for statin users and -0.2±4.2% for control group. There was no statistically significant difference in mean annual spinal BMD changes (P=0.696). The mean annual ALP changes of the study groups were -5.6±18.1% for the statin users and -0.4±13.9% for the control group. There was no statistically significant difference in mean annual ALP changes (P=0.246). In each group, the spinal BMD significantly was not changed after 1 year (P>0.05).

Conclusion : This study suggest that statins do not protect from bone loss in Korean postmenopausal women.
  • 1,290 View
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The Association between C-Reactive Protein and Features of the Metabolic Syndrome.
Yun Jeong Kim, Soon Bok Hwang, Soo Young Kim, In Hong Hwang
J Korean Acad Fam Med 2003;24(5):456-460.   Published online May 10, 2003
Background
: The Metabolic Syndrome is highly associated with an increased risk of coronary heart disease. C-reactive protein (CRP), a sensitive systemic marker of inflammation, is considered to show an association with risk of coronary heart disease. This study was done to assess the association of circulating levels of CRP with different components of the Metabolic Syndrome.

Methods : Total cholesterol (TC), triglycerides (TG), HDL cholesterol, body mass index (BMI), waist circumference, fasting glucose, hemoglobin A1c (HbA1c), blood pressure (BP), and CRP were measured in 1,203 men and women who have visited the Health Promotion Center in Kangdong Sacred Heart Hospital. The relationship of CRP and variables of the metabolic syndrome using t-test and regression analysis as assessed.

Results : CRP was associated with BMI (P<0.001), waist circumference (P<0.0001), diastolic blood pressure (P= 0.004), HDL cholesterol (P=0.015), and TG (P<0.0001). Subjects with the Metabolic Syndrome had a significantly higher CRP concentration (0.89 mg/L) than individuals without the metabolic syndrome (0.33 mg/L, P<0.0001).

Conclusion : CRP seems to be related to variables of the metabolic syndrome. The data suggest that a variety of features of the metabolic syndrome are associated with systemic inflammation.
  • 1,572 View
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Factors Related to Cognitive Impairment of Elderly Patients in Kyongin District.
Ji Won Kang, Sung Taek Kim, Byung Wook Yoo, Jung Eun Oh, Sung Ho Hong, Choo Yon Cho
J Korean Acad Fam Med 2003;24(5):461-472.   Published online May 10, 2003
Background
: With the rapid increase in elderly population arousing from development of medical technology and in standards of living, mental disorders as well as organic disorders according to aging constitute a serious social problem. This study aimed to find a factor related closely to cognitive impairment by analyzing the risk factors influencing cognitive impairment, which is one of the typical geriatric neuropsychiatric conditions.

Methods : This study was conducted using a questionnaire survey and history taking and physical examination was done in 200 elderly patients over sixty-five, who had visited either of the four universities hospitals in the Kyongin district from July 1997 to June 2002. A variety of factors being widely known to be related to cognitive impairment by was investigated using the existing comprehensive geriatric assessment. By using MMSE-K (Korea version of Mini- Mental State Examination), the relation between cognitive impairment and each variable was analyzed by using chi-square test and logistic regression analysis with SPSS 10.0k/PC statistical program.

Results : The number of males and females was 73 (36.5%) and 127 (63.5%), respectively, among the total number of 200 examinees. Males and females having symptoms of cognitive impairment was 25 (34.2%) and 49 (38.6%) among the total number of 74 (37%), respectively. Total mean point of MMSE-K was 24±5.4, 24±5.3 in males and 23.9±5.5 in females. According to the results of multi-variable quantities analysis, it was shown that the cognitive impairment had positive relation to age (P= 0.004), but negative relation to regular exercising (P= 0.016), instrumental activities of daily living (P=0.039) and social support (P=0.003).

Conclusion : The factors having a close relation to cognitive impairment of elderly people were social support, age, regular exercising and instrumental activities of daily living.
  • 1,504 View
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Development of Customized Smoking Cessation Program on the Internet.
Yoo Seock Cheong
J Korean Acad Fam Med 2003;24(5):473-478.   Published online May 10, 2003
Background
: In spite of the harmfulness of smoking, the smoking rate of adult males is high in Korea and those of adolescents and women have risen recently. Although the number of smoking-cessation clinic has risen year by year in Korea, it is not easy for a smoker to attend because of time and economic constraints. This project was performed to allow easy access to on-line smoking counselling center on the internet.

Methods : Smoking cessation homepage (www.xsmoke. net) containing smoking counselling and e-mailing services was developed by Namo web editor, Photoshop 7.0, and MySQL database program.

Results : This program was divided into two major categories: part one was a library of various kind of information on smoking such as articles, lecture notes, pictures, slides, mp3 and motion files. The other part was an autonomous smoking cessation prescription program. This program analyzed smokers' smoking pattern (using WHY test), nicotine addiction level (using Fagerstrom score), stress level (using BEPSI test), and smokers' confidence level. After the input of smoker's history by the applicant, the program showed its smoking cessation prescription automatically and required to give and decide on a quitting day. The next step was automatic e-mailing service containing information on smoking cessation methods.

Conclusion : Internet smoking cessation center that provides a library of smoking cessation materials, automatic prescription and e-mailing program has been developed for Korean smokers.
  • 1,341 View
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