Dementia is the syndrome declined the human cognitive function, especially the memory. It is important that each sub-domain of cognition must be evaluated in the diagnosis of dementia. The neuropsychological test is needed for proper evaluation of the cognitive state of patients suspected dementia. Because many neuropsychological (NP) tests have been developed and validated in Korea, we have to understand the characteristics and the pros and cons of each test. Clinical Practical Guideline (CPG) for dementia has been developed by clinical research center for dementia since 2007 and NP tests that have been used and validated frequently in Korea was presented in this CPG. As elderly population increases, the more patients have been diagnosed as dementia. Therefore, the primary physician examining and diagnosing the dementia patients have to understand the NP test fundamentally.
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Background The prevalence of the metabolic syndrome in Korea is about 20%. The metabolic syndrome is known to increase the risk of cardiovascular disease. However, the relationship of this syndrome with electrocardiographic subclinical risk factors such as corrected QT (QTc) interval prolongation has not been evaluated extensively in Korea. In this perspective, we studied the relationship between metabolic syndrome and QTc interval prolongation among Korean adults. Methods: We analysed 1,560 Korean subjects (men, 873; women, 687; age, 30 to 75 years) at a health promotion center of a university hospital from November, 2006 to Jun, 2007. Subjects were evaluated for metabolic syndrome using a questionnaire, physical examination, blood pressure and blood test. QTc interval was measured from the standard 12-lead electrocardiogram. Results: In women, the odds ratios of QTc interval prolongation according the number 1, 2, 3 ≥ of diagnostic criteria of metabolic syndrome were 1.62 (1.07 to 2.45), 2.70 (1.59 to 4.59), 3.24 (1.65 to 6.32) compared to the number 0 (P for trend < 0.001). In men, the odds ratios according the number 2, 3 ≥ of them were 2.53 (1.56 to 4.11), 3.49 (2.05 to 5.93) (P for trend < 0.001). Conclusion: In Korean Adult, metabolic syndrome is significantly associated with QTc prolongation. As the number of diagnostic criteria of this syndrome increased, the ratio of QTc prolongation tends to be increased. This study suggest that the measurement of QTc interval of subjects with the diagnostic components of this syndrome can help predict cardiovascular risk of prolonged QTc.
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Background The purpose of the study was to understand how family physicians managed their primary health care centers and to identify the factors for successful management of their privative clinics. Methods: The data was collected through individual interviews from five family physicians who operated their private clinics. All interviews were tape-recorded and transcribed into verbatim data. The data was analyzed using qualitative content analysis. Results: Three major categories were identified: 1) types of physician based on major value as a doctor; 2) difficulties in operation and management; 3) desirable operating strategies for success. The first category described what kinds of value the physicians pursued as they operated their private clinics. Two different types were identified. One was intrinsic value oriented and the other was extrinsic value oriented. The second category illustrated many difficulties that family physicians faced in operating and managing their private clinics. Lack of private time, social isolation, and gap between mission and reality of practice were identified as major difficulties. Desirable strategies for the successful management were four subcategories: location; self-oriented developmental plan; specialization of the services; and activating network with larger hospitals. Conclusion: The results of the study would be helpful in setting up and operating private clinics through understanding the difficulties and strategies of primary physicians and recognizing mission and major value of them.
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Background In the primary care setting, compliance with lipid lowering therapy was relatively low. In order to compare the efficacy of a short messaging service (SMS) text messaging and postal reminder as means of improving attendance rates during the first 24 weeks of lipid-lowering therapy, a randomized controlled trial of 918 patients from 19 family practice clinics was conducted between February 2003 and June 2006. Methods: Patients were randomly assigned into 3 groups: SMS (327), postal (294),and control (297) group. To ascertain attendance rates, patients were followed up at 24 weeks after their treatment. Reminders were sent at 16 weeks from the coordinating center. Results: Overall attendance rate was 74.1%. This differed between groups, with 76.1% attendance for the SMS group, 73.5% for the postal group, and 72.4% for the control group. According to a multivariate analysis, the SMS group had a significantly higher attendance rate (Odds ratios [OR] 1.48; 95% confidence interval [CI], 1.01 to 2.16) than the control group, but the postal group (OR, 1.15; 95% CI, 0.79 to 1.69) did not. Moreover, the cost per attendance for the SMS reminder (155 Korean Won [KRW]) was much lower than that for the postal reminder (722 KRW). Conclusion: SMS reminder may be more cost saving method to improve the attendance rate compared with the postal reminder.
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Background Obesity is one of the health problems with high risk of metabolic and physiologic morbidity worldwide. Obesity increases cardiovascular disease risk and death as well as psychological and emotional health problems. Self-efficacy and physical self-efficacy are important evaluation tools for successful diet and exercise in obesity diet practice and it is directly associated with health behaviors. This study conducted to evaluate the effect of weight loss on self-efficacy and life quality.Methods: The 39 adults who joined in weight control program in one public health center were recruited into this study. Quality of life, depression scale, anxiety scale, self-efficacy and physical self-efficacy were examined. Also physical performance ability and weight and lipid profile were examined. Statistical analysis obtained by SPSS.Results: Quality of life and anxiety scale were significantly diminished in obese subjects than non-obese subjects. Quality of life was increased after weight control program in obese subjects. Physical self-efficacy was improved in weight reduction group with much more than 5% of initial weight.Conclusion: Weight reduction has positive impact on psychological aspects in obese subjects. Therefore, we should be more concerned about psychological and functional aspect of obese individuals during weight control treatment.
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Background The chronic liver disease is a relatively common health problem in primary care in Korea. But there are few studies of the prevalence and management status of chronic liver disease in Korea. The aim of this study is to estimate the ratio of health relative behavior among the patients of chronic liver disease, and analyse the association of chronic liver disease with health related behaviors such as private insurance, liver cancer screening examination, smoking, drinking, and exercise.Methods: We analyzed data from the third Korea National Health and Nutrition Examination Survey (KNANES III) 2005. The subjects of this study included the persons over 40 years. We used data about demographics, chronic liver disease, and health behavior data. Results: The prevalence of chronic liver disease was 2.4%. The ratios of private insurance, liver cancer screening examination among the patients of chronic liver disease were 72.6%, 44.2% respectively. The ratios of no smoking, abstinence from drinking, and exercise were 70.0%, 52.6%, and 33.8% respectively. After adjusted with demographic data, the odds ratio of liver cancer screening among the patients of chronic liver disease was 8.4 (P < 0.001), that of abstinence from drinking was 1.2 (P = 0.434). Adjusted odds ratio of private insurance, no smoking and exercise were 1.3 (P = 0.425), 1.2 (P = 0.578), 0.6 (P < 0.05).Conclusion: The primary prevention is less satisfactory than secondary prevention among the patients with chronic liver disease in Korea. In primary care, it is necessary for them not only to check liver cancer screening examination but also encourage no smoking, abstinence from drinking, and exercise.
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Churg-Strauss syndrome is a rare primary vasculitis called allergic granulomatosis angiitis. There is a substantial overlap of symptoms or signs between different vasculitides, so that a diagnosis of any vasculitis can be determined by a combination of clinical symptoms and laboratory tests. We report a case of a 54-year-old woman who had bronchial asthma, eosinophilia, peripheral polyneuropathy, pulmonary infiltrate, maxillary sinusitis, and extravascular eosinophilic infiltration on skin biopsy. So she was diagnosed as having Churg-Strauss syndrome, but she was antineutrophil cytoplasmic antibodies-negative on immunologic study. She had fever and showed cardiac involvement that was presented as cardiomegaly and pulmonary edema at chest radiography and left ventricular hypertrophy on electrocardiography. After steroid therapy, general condition and skin manifestation were rapidly improved.
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