Korean Journal of Family Medicine

"Hong Ji Song"

Original Articles

Clinical Characteristics Associated with Electrocardiographic Left Ventricular Hypertrophy in Clinical Normotensives without a History of Hypertension: a Cross-Sectional Study: Hyoeun Lee, Hong Ji Song, Yu-Jin Paek, Kyung-Hee Park, Hye-Mi Noh, Geonhyeok Kim, Young-Gyun Seo; Korean J Fam Med 2019;40(2):106-115. Published online February 7, 2019; DOI: https://doi.org/10.4082/kjfm.17.0069

Background
This study evaluated factors independently associated with electrocardiographic left ventricular hypertrophy (ECG-LVH) in subjects who were normotensive on clinical measurement and had no prior history of hypertension.
Methods
This cross-sectional study analyzed cases and controls in the Comprehensive Medical Examination Center of Hallym University Sacred Heart Hospital. Eligible case participants presented ECG-LVH according to the Sokolow-Lyon or Cornell criteria, were normotensive on clinical measurement, and had never received a diagnosis of hypertension. The control group comprised subjects with normal sinus rhythm who were normotensive on clinical measurement with no history of hypertension.
Results
A multiple logistic regression model showed male sex, age and systolic blood pressure to be positively related to the presence of ECG-LVH. A positive relation of smoking and regular exercise; an inverse relation of pulse rate to the presence of ECG-LVH were found only in men. An inverse relation of uric acid level was found only in women. Detailed analyses of relatively healthy and young men according to whether or not to exercise regularly showed that positive relations of age and systolic blood pressure; an inverse relation of obesity to the presence of ECG-LVH were apparent in the non-regular exercise group but not in the regular exercise group. In the regular exercise group, only pulse rate showed significant (inverse) association with the presence of ECG-LVH.
Conclusion
The varying risk factor profiles associated with ECG-LVH according to sex and the participation in regular exercise may help to elucidate the ECG-LVH in clinical normotensives with no prior history of hypertension.

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Prevalence, Performance and Predictors of Electrocardiographic Left Ventricular Hypertrophy in Male Black Athletes: A Retrospective Study
Tochukwu F. Ilodibia, Clement O. Odigwe, Augustine N. Odili
Indian Journal of Clinical Cardiology.2024; 5(1): 15. CrossRef

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Differences in Factors Associated with Albuminuria according to Gender and Comorbidities of Hypertension and Diabetes: Miae Jang, Sohee Oh, Hye-Mi Noh, Sunyoung Chun, Hye young Oh, Kyung Hee Park, Yu Jin Paek, Hong Ji Song; Korean J Fam Med 2015;36(6):316-322. Published online November 20, 2015; DOI: https://doi.org/10.4082/kjfm.2015.36.6.316

Abstract
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Background

This study examined the differences in factors associated with albuminuria according to gender and comorbidities of hypertension (HTN) and diabetes mellitus (DM).

Methods

We included 3,859 participants aged 20 to 79 years (55% female) from the 5th Korea National Health and Nutrition Examination Survey. Participants were excluded if they took antihypertensive or anti-diabetic medication, had chronic renal failure, had malignant tumor, were pregnant or menstruating during the health examination, or had missing urine albumin data. Albuminuria was defined by the participant's urine albumin-creatinine ratio (uACR). Relationships between dependent and independent variables were analyzed using the Pearson's correlation test and simple linear regression. Due to possible muticollinearity, multiple linear regression analysis was used to determine whether the association between the dependent and independent variables of interest remained significant after adjustment for other potentially confounding independent variables.

Results

The variables significantly correlated with uACR were different between the genders and between subjects with HTN or DM as a comorbidity. In the multiple linear regression models, hemoglobin A1c (P=0.01) was positively associated with uACR in men without HTN and DM. In men with HTN or DM, systolic blood pressure and fasting glucose (P<0.01) were positively associated with uACR. In women with HTN or DM, waist circumference (P=0.011) and gamma-glutamyl transpeptidase (P<0.001) were positively correlated with uACR (P<0.05) and glucose level (P=0.019) was negatively correlated with uACR.

Conclusion

The study suggested factors correlated with albuminuria were different for men and women according to comorbidities such as HTN and DM.

Citations

Citations to this article as recorded by

Sex-Specific Predictors of Microalbuminuria in Type 2 Diabetes: A Cross-Sectional Study
Eun Sook Bae, Hye Seung Kang
Korean Journal of Adult Nursing.2025; 37(3): 287. CrossRef
High prevalence of albuminuria among adult males living with HIV in Botswana
Mosepele Mosepele, Ponego Ponatshego, Kesaobaka Molebatsi, Christopher Williams, Lucky Mokgatlhe, Shahin Lockman, Nabila Youssouf, Robert Gross, Joseph Jarvis, Duolao Wang, Shabbar Jaffar
Scientific Reports.2024;[Epub] CrossRef
Relationship between serum and tear levels of tissue plasminogen activator and plasminogen activator inhibitor-1 in diabetic retinopathy
Nurbadriah binti Jasmiad, Rohana binti Abd Ghani, Renu Agarwal, Zaliha binti Ismail, Azlindarita Aisyah Mohd Abdullah, Mohd Yusri Idorus
BMC Ophthalmology.2022;[Epub] CrossRef
Prevalence of micro albuminuria and diagnostic accuracy of urine dipstick for the screening of diabetic nephropathy in type 2 diabetes patients
Sindhu Varghese, S. Gowtham Kumar
Biocatalysis and Agricultural Biotechnology.2019; 21: 101316. CrossRef
Differential Association of Vitamin D Deficiency With Albuminuria by Sex in the Korean General Population: A Cross-sectional Study of the Korea National Health and Nutrition Examination Survey 2011-2012
Yongwoo Jeon, Jaeyong Shin, Jong Hyun Jhee, Youngdae Cho, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2018; 51(2): 92. CrossRef

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Time to First Cigarette and Hypertension in Korean Male Smokers: Saerom Lee, Miae Jang, Hye-Mi Noh, Hye-Young Oh, Hong Ji Song, Kyung Hee Park, Yu-Jin Paek; Korean J Fam Med 2015;36(5):221-226. Published online September 18, 2015; DOI: https://doi.org/10.4082/kjfm.2015.36.5.221

Abstract
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Background

Morning blood pressure surge affects to cardiovascular disease risk. Short time to first cigarette (TTFC) after waking can enhance morning blood pressure surge, and accelerate atherosclerosis

Methods

We investigated that the relationship between TTFC and blood pressure. The study subjects included male current smokers (n=211) who had health check-up in Hallym University Sacred Heart Hospital from July to September, 2014. We categorized the subjects into 2 groups according to TTFC; early TTFC (TTFC <30 minutes) and late TTFC (TTFC ≥30 minutes), and the subjects who were taking antihypertensive medications or had a high blood pressure (>140 mm Hg or 90 mm Hg) were defined as hypertensive group. Multivariate logistic regression was performed to estimate the odds ratio and 95% confidence interval to investigate the association between TTFC and hypertensive group.

Results

Compared with late TTFC, early TTFC had higher odds (odds ratio [OR], 3.87; 95% confidence interval [CI], 1.89-7.94) for hypertensive group. After adjusting confounding factors, early TTFC was significantly associated with an increased risk of hypertension (OR, 4.43; 95% CI, 1.84-10.70).

Conclusion

early TTFC after waking is associated with hypertension. It suggests delaying TTFC might help to control of blood pressure among the current smokers who are not ready to immediately quit smoking.

Citations

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Smoking Timing, Healthy Diet, and Risk of Incident CKD Among Smokers: Findings From UK Biobank
Rui Tang, Ying Hu, Jian Zhou, Xuan Wang, Xiang Li, Yoriko Heianza, Lu Qi
American Journal of Kidney Diseases.2024; 84(5): 593. CrossRef
Time from waking to the first cigarette and mortality and incident cardiovascular disease
Yanzhi Li, Wenjian Lai, Hao Zhao, Xiali Zhong, Lan Guo
Journal of Public Health.2024; 46(4): 487. CrossRef
Alcohol and Nicotine Dependence and Time to Death in a General Adult Population: A Mortality Cohort Study
Ulrich John, Hans-Jürgen Rumpf, Monika Hanke, Christian Meyer
European Addiction Research.2023; 29(6): 394. CrossRef
Time to First Cigarette and the Risk of Hypertension: A Nationwide Representative Study in Korea
Jinok Bae, Yu Hyeon Yi, Yun Jin Kim, Jeong Gyu Lee, Young Jin Tak, Seung Hoon Lee, Hye Rim Hwang, Sang Yeoup Lee, Young Hye Cho, Ei Jin Ro
American Journal of Hypertension.2019; 32(2): 202. CrossRef
Comments on Statistical Issues in November 2015
Kyung Do Han, Yong Gyu Park
Korean Journal of Family Medicine.2015; 36(6): 357. CrossRef

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Review

The Comparison of Guidelines for Management of Dyslipidemia and the Appropriateness of Them in Korea.: Young Gyu Cho, Hong Ji Song, Byung Ju Park; Korean J Fam Med 2010;31(3):171-181. Published online March 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.3.171

Abstract
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There have been accumulating evidences that dyslipidemia is a major risk factor of cardiovascular disease (CVD) and improvement in lipid profile can reduce the incidence of CVD. Guidelines for management of dyslipidemia have been developed by major organizations in several contries including the United States. In Korea, a guideline was also published by the Korean Society of Lipidology and Atherosclerosis. However, This guideline was not based on evidences in Korea, but was made by a consensus of experts using a pre-developed guideline as a reference. For clinical application for Korean of guidelines developed in different nations, the disease epidemiology and medical environment in Korea should be considered. In this article, we reviewed whether guidelines for management of dyslipidemia are applicable in Korean context.

Citations

Citations to this article as recorded by

A Possible Case of Statin-Induced Ichthyosis in an Elderly Woman
Ki Dong Ko, Kyoung Kon Kim, Jin-Ok Baek, Heuy Sun Suh, In Cheol Hwang
Korean Journal of Family Medicine.2018; 39(1): 51. CrossRef
Relationship between health behaviors and high level of low density lipoprotein-cholesterol applying cardiovascular risk factors among Korean adults: based on the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013 ~ 2015
Bo-Kyoung Cha
Journal of Nutrition and Health.2018; 51(6): 556. CrossRef
Management Status of Cardiovascular Disease Risk Factors for Dyslipidemia among Korean Adults
Jongseok Lee, Heejeong Son, Ohk-Hyun Ryu
Yonsei Medical Journal.2017; 58(2): 326. CrossRef
The Effect of Omega-3 Fatty Acid Supplementation on Cerebral Blood Flow and Vascular Resistance: A Preliminary Study
Jae-Hyeok Heo, Hye-Yeon Won, Dong-Gyu Im, Jung-Hee Kim, Hee-Tae Kim, Jin-Young Ahn
Korean Journal of Clinical Neurophysiology.2015; 17(2): 68. CrossRef
Prevalence and Management of Dyslipidemia Among Korean Adults: KNHANES 2010-2012
Sungok Jang, Jongseok Lee
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(11): 7978. CrossRef

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Original Articles

Relationship between Brand Nicotine Yield of Cigarettes and Urine Cotinine Level in Male Smokers.: Sang Ho Yoon, Yu Jin Paek, Sang Ho Yoo, Jung Jin Cho, Hong Ji Song, Kyung Hee Park, Hye Mi Chang, Jin Hwa Ban; Korean J Fam Med 2009;30(9):703-709. Published online September 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.9.703

Abstract
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Background
As one of harm reduction strategies, tobacco manufacturers have begun to introduce lower-yield cigarettes. Lower-yield cigarettes, so called light cigarettes, have been perceived as less hazardous by some smokers. However, there have been very few studies concerning smoking lower yield products the lead to lower nicotine absorption. We evaluated the association between brand nicotine yield of cigarettes and actual nicotine intake by measuring urinary cotinine. Methods: Four hundred sixty four male smokers aged 18 or over who participated in health check-ups in a hospital from May to October 2007 fi lled out a self-administered smoking questionnaire. Urinary cotinine concentration was measured at the time of participation. The subjects were divided into three groups (ultralight [nicotine: 0.05 mg], light [0.1 mg], and regular [> 0.1 mg] group) according to the level of brand nicotine yield of cigarettes which they smoked. Results: The median urinary cotinine concentrations of ultralight (N = 62), light (N = 216), and regular (N = 186) groups were 735.5 ng/mL (interquartile range, 320 to 1,300 ng/mL), 956.0 ng/mL (429 to 1,491 ng/mL), and 1,067.5 ng/mL (615 to 1,613 ng/mL), respectively. There was a signifi cant difference in urinary cotinine between the regular and the other groups (P = 0.015). However, multiple logistic regression analysis to evaluate the risk of being in the highest quartile of urinary cotinine concentration (≥ 1,532 ng/mL) after adjusting for possible confounding variables showed that the odds ratios were 0.84 (95% CI, 0.52 to 1.37) in the light nicotine group and 0.82 (95% CI, 0.38 to1.72) in the ultralight nicotine group compared to the regular nicotine group. Conclusion: There was no significant difference in the risk of elevated urinary cotinine concentrations in male adult smokers according to brand nicotine yield of cigarettes groups.

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Prevalence of the Metabolic Syndrome in Korean Children and Adolescents according to the International Diabetes Federation Definition in Children and Adolescents.: Young Gyu Cho, Hong Ji Song, Jae Heon Kang; Korean J Fam Med 2009;30(4):261-268. Published online April 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.4.261

Abstract
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Background
Many children and adolescents are exposed to the risk of cardiovascular diseases because of increase in obesity and obesity-related metabolic derangements in children and adolescents. The diagnosis of the metabolic syndrome is useful to identify these children with high cardiovascular risk. In 2007, the International Diabetes Federation (IDF) presented a new defi nition of the metabolic syndrome for children and adolescents. The aim of this study was to estimate the prevalence of the metabolic syndrome using the IDF pediatric defi nition in Korean children and adolescents.Methods: We used data from 931 participants aged 10-19 years in the Korean National Health and Nutrition Examination Survey 2005. The metabolic syndrome was diagnosed by the new IDF pediatric defi nition.Results: The prevalence of the metabolic syndrome in Korean children and adolescents aged 10-19 years was 2.0 ± 0.5% (boys: 3.1 ± 0.8%, girls: 0.8 ± 0.4%). Approximately 95% of children and adolescents with the metabolic syndrome was classifi ed with obesity and none of the normal-weighted participants were diagnosed with the metabolic syndrome.Conclusion: The prevalence of the metabolic syndrome in Korean children and adolescents was 2.0 ± 0.5%. It is expected that the new IDF pediatric defi nition will help to detect children with high cardiovascular risk early and to manage them properly. However, whether the IDF pediatric defi nition of the metabolic syndrome and cut-off points of its components are appropriate for Korean children and adolescents should be answered through future research.

Citations

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Association between mothers’ working hours and metabolic syndrome in children and adolescents: data from the Korea National Health and Nutrition Examination Survey, 2016–2020
Myoung-hye Lee, Joo-Eun Jeong, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park
Korean Journal of Family Medicine.2025; 46(2): 84. CrossRef
Prevalence Trends of Metabolic Syndrome among Korean Children and Adolescents from a Population-Based Cross-Sectional Survey
Ji Hyun Kim, Jung Sub Lim
Life.2022; 12(9): 1404. CrossRef
The Prevalence of Metabolic Syndrome According to Grip Strength in Teenagers
Duk Han Ko, Young Kyun Kim
Children.2021; 8(2): 108. CrossRef
Prevalence of Metabolic Syndrome among Children and Adolescents in High‐Income Countries: A Systematic Review and Meta‐Analysis of Observational Studies
Zebenay Workneh Bitew, Ayinalem Alemu, Zelalem Tenaw, Animut Alebel, Teshager Worku, Ermias Getaneh Ayele, Ali Abbara
BioMed Research International.2021;[Epub] CrossRef
Prevalence of Metabolic Syndrome among Korean Adolescents According to the National Cholesterol Education Program, Adult Treatment Panel III and International Diabetes Federation
Seonho Kim, Wi-Young So
Nutrients.2016; 8(10): 588. CrossRef
Prevalence of Metabolic Syndrome and Metabolic Abnormalities in Korea Children and Adolescents and Nutrient intakes: Using 2008 the Korea National Health and Nutrition Examination Survey
Hang-Me Nam, Mi-Ja Choi
Korean Journal of Community Nutrition.2014; 19(2): 133. CrossRef
An analysis of long-term occurrence of renal complications following pediatric pyeloplasty
Hahn-Ey Lee, Kwanjin Park, Hwang Choi
Journal of Pediatric Urology.2014; 10(6): 1083. CrossRef
The Effects of Lifestyle Factors on Metabolic Syndrome among Adolescents
Hanju Lee
Journal of Korean Public Health Nursing.2014; 28(2): 270. CrossRef
Relationships between the Change in Obesity Rate and Risk Factors of Metabolic Syndrome among Middle School Students in Ulsan
Soon-Ho Choi, Song-Woo Shin, Cheol-In Yoo
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(11): 5271. CrossRef
Dietary and Lifestyle Factors Associated with Hypertension in Korean Adolescents -Based on 2005 Korean National Health and Nutrition Examination Survey-
Killye Kim, Sook Mee Son, Hye-Kyeong Kim
Korean Journal of Community Nutrition.2011; 16(4): 439. CrossRef
Association of Visceral Fat and Risk Factors for Metabolic Syndrome in Children and Adolescents
Jeong-Hyeon Kwon, Han-Yun Jang, Min-Jin Oh, Jun-Seung Rho, Ju-Hye Jung, Keun-Sang Yum, Ji-Whan Han
Yonsei Medical Journal.2011; 52(1): 39. CrossRef
The metabolic syndrome and sports medicine
Yun Jun Yang
Journal of the Korean Medical Association.2011; 54(7): 697. CrossRef
Association with Self-Perception for Obesity and Mental Health among Korean Adolescent
In-Cheol Hwang, Kyoung-Shik Lee, Dong-Kyun Park, Eun-Young Jung, Chung-Hyun Choi, Seong-Jin Cho, Seung-Min Bae
Journal of Child and Adolescent Psychiatry.2011; 22(2): 112. CrossRef
Lifestyle Habits Related to Abdominal Obesity in Korean Adolescents
Won-Chin Chung, Young-Gyu Cho, Jae-Heon Kang, Hyun-Ah Park, Kyoung-Woo Kim, Joo-Ho Kang, Nu-Ri Kim, Hye-Jin Kim, Ok-Hyun Kim
Korean Journal of Family Medicine.2010; 31(7): 547. CrossRef
Metabolic syndrome in children and adolescents
Young Mi Hong
Korean Journal of Pediatrics.2009; 52(7): 737. CrossRef

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Association between Depression and Cardiovascular Risk Factors in Workers Undergoing Comprehensive Medical Examination in a University-based Hospital.: Jong Won Choi, Jung Jin Cho, Hye Mi Chang, Chan Won Kim, Yu Jin Paek, Hong Ji Song, Kyung Hee Park, Whanseok Choi; J Korean Acad Fam Med 2008;29(9):645-650. Published online September 10, 2008

Abstract
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Background: Depression increases the risk of cardiovascular risk factors in adults. However, the association between depression and cardiovascular risk factors was not well evaluated in South Korea. Our study was done to evaluate the association between depression and cardiovascular risk factors in workers. Methods: The study population was selected among adults working in several industries that had more than 50 employees. They had received their medical examinations at the Health Promotion Center of Hallym University Sacred Heart Hospital between March and November 2005. We estimated the odds ratio to determine whether depression (Korean Center for Epidemiologic Studies Depression Scale score ≥21) was associated with each cardiovascular risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity). Results: The prevalence of depression was 15.5%. Depression was significantly associated with hypertension (P＜0.001), obesity (P=0.03) and hypercholesterolemia (P=0.004). The adjusted odds ratio for hypertension and hypercholesterolemia were 1.41 (95% CI 1.04∼1.91) and 1.59 (95% CI 1.05∼2.40), respectively. The association between depression and obesity was eliminated after adjustment (1.25, 95% CI: 0.97∼1.61). Conclusion: Depression was significantly associated with hypertension and hypercholesterolemia in workers. Further long-term study on the association of depression with cardiovascular risk factors is necessary. (J Korean Acad Fam Med 2008;29:645-650)

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Percent Body Fat and Abdominal Circumference Cutoff Points Accounted for 85th and 95th Percentile of Body Mass Index in One City of Gyeonggi Province.: Chan Won Kim, Kyung Hee Park, Young Su Ju, Hong Ji Song, Yu Jin Paek, Jong Won Choi, He Mi Chang, Jung Jin Cho; J Korean Acad Fam Med 2008;29(7):492-498. Published online July 10, 2008

Abstract
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Background: Childhood obesity is becoming more prevalent, associated with a variety of adverse consequences which leads to adulthood obesity. Although diagnosis is usually made by body mass index, there is neither a cutoff point for the percentage body fat nor abdominal circumference. The aim of this study was to identify each cutoff point for both measures. Methods: The measurement of height, weight, abdominal circumference and percentage body fat was performed through manual assessment and bioelectrical impedance analysis for 4,242 subjects aged 11 in Gunpo City, South Korea. The cutoff point for body fat percentage and abdominal circumference is set to maximize the sum of sensitivity and specificity for detecting obesity and overweight using the Receiver Operating Characteristics (ROC) curve. Results: The mean percentage body fat was 13.6±6.9% for boys and 19.4±5.3% for girls. The mean abdominal circumference of boys was 68.0±9.1 cm, and that of girls was 64.3±7.7 cm. The cutoff point of percentage body fat for obesity was 21.8% in boys and 24.5% in girls. The prevalence of obesity was 15.2%, 16.7% for males and females, respectively. The abdominal circumference cutoff for obesity was 76.9 cm in boys and 70.7cm in girls. Based on that, the prevalence of obesity was 19.7% for boys and 20.0% for girls, which was higher than what was identified by body mass index, as in the case of body fat percentage. Conclusion: The cutoffs of body fat percentage and abdominal circumference in one city of Gyeonggi Province were lower than those suggested in the previous studies. (J Korean Acad Fam Med 2008;29:492-498)

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Beta-glucan for Glycemic Control Effects in Adults: a Meta-analysis.: Gyo Soon Hwang, Yong Kyun Roh, Hong Ji Song, Yoon Young Lee, Hyung Joon Kim, In Hong Hwang, Soo Young Kim, Hye Min Cho; J Korean Acad Fam Med 2008;29(7):475-483. Published online July 10, 2008

Abstract
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Background: Recently, there has been an increase of emerging concerns between dietary fiber and diabetics. Increasing intake of dietary fiber leads to delaying absorption of glucose, and lowering of serum insulin levels. In the past studies, there were inconsistent glycemic control effect of beta-glucan. Our purpose was to assess the glycemic control effect of beta-glucan in adults. Methods: Electronic searches (Cochrane, PubMed, EMBase), hand-searching and review of reference were done. The search term for beta-glucans [mh], "Avena sativa" [mh], "Hordeum" [mh], beta glucan* [tw], oat [tw], barley [tw], with no language restriction were used. All RCT that included available data of beta-glucan or that could impute dose of beta-glucan, at least one relevant outcome of glycemic control, run-in period more than 2 weeks, and intervention period of more than 2 weeks or greater were selected. A fixed-effect model was used to assess the summary effect of studies. Results: A total of 43 articles were identified, 4 studies met our inclusion criteria and then analyzed. In pooled analysis, the effect size of fasting glucose level was 0.13 (95%CI: −1.25 to 1.51), and serum insulin level was −0.95 (95%CI, −2.37 to 0.47). It was impossible to adjust for sex and age owing to the lack of raw data. Conclusion: In this review, the results suggested that there were negative impacts of beta-glucan on fasting glucose and serum insulin level in adults, but we concluded that there was insufficient evidence to confirm about glycemic control effect. More powerful and well-designed RCT were required to confirm about glycemic control effect of beta-glucan. (J Korean Acad Fam Med 2008;29:475-483)

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Review

Adverse Drug Reaction Surveillance and the Role of Family Physicians.: Hong Ji Song, Nam Kyong Choi, Byung Joo Park; J Korean Acad Fam Med 2007;28(11):815-823. Published online November 10, 2007

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Original Articles

The Association between Gamma-glutamyltransferase and Metabolic Syndrome in Korean Male Workers.: Young Gyu Cho, Hong Ji Song, Hyung Jin Chung, Jung Jin Cho, Yu Jin Paek, Kyung Hee Park, Jung Soo Byun; J Korean Acad Fam Med 2007;28(1):45-50. Published online January 10, 2007

Abstract
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Background
: Serum Gamma-glutamyltransferase (GGT) has been used clinically as a marker for excessive alcohol consumption or liver diseases, but it was reported recently that GGT is associated with cardiovascular disease. This study was done to verify the association between GGT and the metabolic syndrome in Korean male workers.

Methods : Total cholesterol, triglycerides, HDL cholesterol, body mass index (BMI), waist circumference, blood pressure, fasting glucose, uric acid, and GGT were measured and liver US was performed in 1,215 male workers who underwent annual health check up in a university health promotion center from May to October 2003. The association of GGT with the metabolic syndrome was assessed.

Results : The mean age of subjects was 41.9±7.2 years and the mean BMI was 24.1±2.7 kg/m². A raised GGT level (GGT＞75 IU/L) was seen in 172 of 1,136 (15.1%) and the prevalence of the metabolic syndrome was 9.9% (112/1,136). Individuals with the metabolic syndrome had a higher mean GGT concentration (53.4 IU/L) than individuals without the metabolic syndrome (34.4 IU/L; P＜0.001). The subjects with increased GGT showed more risk of metabolic syndrome than the subjects with normal GGT by multivariate analysis (OR=2.835). Subgroup analyses did not change the association between the GGT and the metabolic syndrome.

Conclusion : This study showed that the serum GGT was associated with the metabolic syndrome and that increased GGT was another feature of the metabolic syndrome.

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Mammographic Breast Density and Risk Factors of Breast Cancer in Korean Women Using Multicenter Study.: Jung Jin Cho, Hong Ji Song, En Young Koh, Yun Mi Song, Boo Kyung Han, Young Sook Yun, Hyun Ah Park, Sung Hee Lee, Jeong Hee Yang, Heon Han, Young Ran Seo; J Korean Acad Fam Med 2006;27(1):33-41. Published online January 10, 2006

Abstract
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Background
: Density patterns on mammography have been related to the risk factors for breast cancer in the western countries. High mammographic density appears to confer a 4-fold risk of breast cancer. While the proportion of high-density mammography is higher in Korean women than in Caucasian women, the incidence of breast cancer in Korean women is considerably lower. Therefore, we examined if the mammographic breast density pattern correlates with the risk factors for breast cancer in Korean women.

Methods : In a cross-sectional design, we recruited 1,758 pre- and post-menopause women without prior history of breast cancer and breast surgery who underwent screening mammogram and completed a self-administered questionnaire in 6 general hospitals. On the basis of ACR BI RADS breast composition, four density patterns were classified in caudocranial and mediolateral mammography by a designated radiologist in each hospital. Multiple linear logistic regression was used for statistical analyses.

Results : Inter-rater reliability between the initial report and the report made by another blinded radiologist was high (Pearson's co-efficient=0.81). Overall, the age, body mass index, family history of breast cancer, and duration of hormone replacement therapy correlated with the mammographic density patterns. In pre-menopausal women, the high body mass index and parity (=2) were associated with low mammographic density. In post- menopausal women, older age, high body mass index, negative family history of breast cancer, and duration of hormone replacement therapy were associated with low mammographic density.

Conclusion : Our data showed that the mammographic breast density patterns correlated with risk factors for breast cancer in Korean women. While the proportion of high-density mammography is higher in Korean women, the incidence of breast cancer is lower than in the western population. This maybe dependent on other unknown factors.

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The Association between C-reactive Protein and Smoking Characteristics among Korean Men.: Joung Ki Choun, Yu Jin Paek, Jung Soo Byun, Kyung Hee Park, Hong Ji Song, Jung Jin Cho; J Korean Acad Fam Med 2005;26(10):621-628. Published online October 10, 2005

Abstract
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Background
: C-reactive protein is a substance that elevates when there is an abnormal metabolic reaction or inflammatory condition. Some researchers in Korea reported different results about the association between smoking and CRP. In this study, the relationship between CRP and various smoking characteristics among Korean men was investigated.

Methods : Data were analyzed in healthy men, who had visited a health promotion center in a university hospital from September, 2003 to December, 2003. CRP was quantitatively analyzed by high sensitivity-CRP. Elevated CRP (≥2.2 mg/L) level in relation to various smoking characteristics were studied and multiple logistic regression analysis for elevated CRP (≥2.2 mg/L) level was conducted.

Results : The number of current smokers was 893, past smokers 550, and non-smokers 413. The association between smoking status, daily smoking amount, duration of smoking (P=0.031, P=0.003, P=0.034) and elevated CRP level was shown by chi-square test. After multiple logistic regression analysis for risk factors, elevated CRP level was shwon to be associated with daily smoking amount in the current smokers, body fat percentage, WBC count and HDL-cholesterol. The odds ratios for elevated CRP level by smoking amount were 2.32 (95% confidence interval 1.11∼4.85) in those who smoked 10∼19 cigarettes per day, 3.54 (95% confidence interval 1.64∼7.63) in those who smoked more than 20 cigarettes per day compared to those who smoked less than 10 cigarettes per day.

Conclusion : Among current smokers, elevated CRP level was associated with daily smoking amount in the current smokers, This is the first study to report the relationship between CRP level and smoking behaviors among Korean men.

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Erectile Dysfunction and Risk Factors.: Se Hoon Lee, Hong Ji Song, Jung Jin Cho, Jong Lull Yoon, Se Ra Hong, Kyung Hee Park, Young Su Ju; J Korean Acad Fam Med 2004;25(8):603-609. Published online August 10, 2004

Abstract
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Background
: Erectile dysfunction (ED) has been presented as a predictor of cardiovascular diseases. Earlier studies had revealed risk factors for erectile dysfunction, but the results are variable. We conducted this study to evaluate the association between various factors and ED.

Methods : The subjects were 403 men, over 20 years old, who visited a university hospital health promotion center from February to May 2003. They responded to 'the Korean version of 5-item International Index of Erectile Function (IIEF-5)'. The subjects were divided into ED group and normal group according to 'IIEF-5' score. We studied the association between ED and sociodemographic factors, smoking, exercise, depression, diabetes, hypertension, dyslipidemia and analysed stress and job stress in a subgroup who responded to the questionnaires.

Results : The mean age of subjects was 45.6±8.9 and 34.2% of the subjects had ED. The risk of ED increased 1.09 times per year (P＜0.01). Statistically significant association between ED and education level, income, occupation, smoking (P＜0.01), DM, and exercise (P＜0.05) was shown by univariate analysis, but not by multivariate analysis. By multivariate analysis, the risk of ED increased significantly in older age, lower educational group and severe depression (P＜0.01). Among 251 subjects who completed the Psychiatric Wellbeing Inventory- Short form, high risk of stress group wsa associated with high risk of ED by univariate analysis (P＜0.01) but this association did not exist in multivariate analysis. We could not find the association between ED and job stress.

Conclusion : The prevalence of ED was 34.2% among the subjects over 20 year-old and the risk of ED increased significantly in older age, lower educational group, and in subjects who had moderate to severe depression.

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A Selection and Translation of Evidence Based Clinical Practice Guidelines for Primary Care Physician in Respiratory Disease Field.: Soo Young Kim, Inhong Hwang, Jong Lull Yoon, Jung Jin Cho, Young Ho Choi, Yong Gyun Rho, Yoo Sun Moon, Mee Young Kim, Yu Jin Paek, Hong Ji Song, Kyung Hee Park; J Korean Acad Fam Med 2004;25(3):205-215. Published online March 10, 2004

Abstract
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Background
: One method for achieving medical practice to be more evident, especially in the field of primary care, is to encourage the use of clinical guidelines. If development of guidelines is difficult because of time and cost, an evidence based foreign guidelines can be selected and translated into Korean for application.

Methods : A team was formed, consisting of 11 family physician experts on evidence based medicine and clinical practice guidelines. We selected six respiratory diseases requiring clinical guidelines because of variability in practice. We searched several clinical practice guideline databases and selected one guideline according to currency, scope of guideline, whether it was evidence based, and its feasibility in the field of primay care. We translated selected guideline's full-texts or summaries which were done by authorized organization into Korean.

Results : The selected respiratory diseases were chronic obstructive pulmonary disease, asthma, pneumonia, sinusitis, rhinitis, and influenza. According to criterion, we selected GOLD (Global Initiative for Chronic Obstructive Lung Disease) for chronic obstructive lung disease, GINA (Global initiative for asthma) for asthma, CDC (Center for disease control) guideline for influenza, IDSA (Infectious Diseases Society of America) guideline for pneumonia, AAP (American Academy of Pediatrics) guideline for sinusitis, and JCAAI (Joint Council of Allergy, Asthma and Immunology) for rhinitis.

Conclusion : We selected six common respiratory diseases and the most appropriate evidence based guidelines for those particular diseases.

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Health status and behavior of homeless in Seoul.: Hong Ji Song, Chong Hee Cho, Jae Heon Kang, Won Sook Hwang, Hea Keyng Han; J Korean Acad Fam Med 2000;21(3):357-366. Published online March 1, 2000

Abstract
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Background
: Since recent economic crises (IMF) in Korea, the number of new homeless is increasing(that is, ‘IMF style homeless’). There are only few studies on the health problem of this uniquely formed population. We have attempted to estimate the problem of health behavior and health status of this population.

Methods : Some homeless who agreed to enter the asylum during the winter were taken for medical check-up in Sunbuk Community Health Center from November to December, 1998. The participants filled up a self-reported questionnaire and physical examination, laboratory test, and chest x-ray were performed.

Results : Among ‘IMF style homeless’, the prevalence of hypertension(30.9% in primary screening, 7.3% in secondary screening), diabetes mellitus(9.4% in primary screening, 3.5% in secondary screening), syphilis(7.3%), and hepatitis B antigen carrier(5.3%) was higher than among the general population. But we could not find statistical difference according to the duration of homelessness. We found higher smoking rate and higher alcohol drinking amount per week in homeless than in the general population. The amount of alcohol drinking per week larger among those who had been homeless for more than 3 months (p<0.01).

Conclusion : The prevalence of chronic diseases in homeless was higher than in the general population, but statistical difference according to the duration of homelessness could not be found. The longer the duration of homelessness, the larger the amount of alcohol drinkin was seeing.

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The factors associated with satisfaction about body image and weight control behaviors in adolescents.: Hong Ji Song, Mee Sook Oh, Sung Hoon Ahn, Min Seon Park, Tai Woo Yoo, Jae Heon Kang, Young In Choi; J Korean Acad Fam Med 1999;20(4):345-357. Published online April 1, 1999

Abstract
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Background
: Obesity is not only one of the risk factors that affects the prevalence and aggravation of chronic diseases, but is also the cause of social unfitness because slimness has become a standard of beauty. We surveyed on the satisfaction about self body image, the factors which are related to it and weight control behavior of the adolescents in a local area of Korea. Methods : The survey was performed in a high school of Pocheon on August, 1996. Five classes out of 14 classes in 1st and 2nd grade were selected. The body mass index(BMI) was calculated from the measured height and weight. The satisfaction about body image which was estimated by the difference between present body image and wanted body image in 9 graded figures of body image was obtained from the questionnaire. The information about sex, religion, history of being teased about body image, body image of their parents, mean duration of watching TV in a day, body esteem, and binge-eating was obtained from the questionnaire and we evaluated the relationship between all of the above with BMI and body image satisfaction. We also investigated on the interest in education about weight control and efforts made by adolescents from the questionnaire on weight control behavior. Results : Total of224 students participated in this study and only 14.7% of them were satisfied with their body image. 58.9% wanted weight reduction and 26.4% wanted weight gain. They were more dis-satisfied with their body image when they were girls(p<0.01), had the experience of being teased about their body image(p<0.01), had low body esteem(p<0.01), and had high BMI(p<0.01). We could not find statistically significant relationship between body image satisfaction and other factors such as religion, the duration of watching TV in a day, the body image of their parents and binge eating. 64.3% of the subjects tried to control their weight and most(87.5%) tried to lose wight. The selected methods were diet control(65.3%) and exercise(52.1%) and the most preferred method of diet control was skipping meals(45.7%). Conclusion : Most of adolescents were not satisfied with their body image and this dissatisfaction was related to gender, history of being teased about their body image, BMI, and body esteem. Many of them had tried to lose weight and among the methods of weight reduction, there behaviors that were injurious to their health and growth.

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A Study of the core curriculum of family medicine residency Program in Korea.: Han Seung Song, Sung Il Hong, Kyung Hwan Cho, Hong Ji Song, Choon Woo Lee, Sun Mee Kim, Myung Ho Hong; J Korean Acad Fam Med 1998;19(10):820-827. Published online October 1, 1998

Abstract
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Background
: In order to provide basic data which are necessary for the standard reference of residency training program in family medicine, we analysed of family practice residency program in Korea(the core curriculum) which has 313 items - diseases and problems - proposed by the Korean Academy of Family Medicine.

Methods : Each item of the core curriculum of family practice residency program in Korea was sorted according to ICD-10. They were the most compared to common 100 diseases and clinical cases in family medicine department of a tertiary hospital in one year. The most common 100 diseases were listed according to ICD-10, also. But some items which were difficult to sort were excluded. Eighty eight types of diseases were sorted. Clinical data of a tertiary hospital included 9138 cases.

Results : Comparing to clinical cases of a tertiary hospital, the core curriculum includes 93.2% cases of family medicine department of a tertiary hospital. Among the 17 fields of the core curriculum, 12 fields were found in about 50% or more among cases of the clinic and 5 fields were in less than 50%.
Among 88 diseases, the core curriculum includes 78 diseases. 10 diseases were excluded. In the most common 100 diseases, 12 diseases were related to trauma and the core curriculum did not include them.

Conclusion : Generally the core curriculum included highly prevalent diseases, but did not include some diseases which is important. Revision to make up for the weak points in the current core curriculum may be necessary.

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Symptoms related to low systolic blood pressure.: Dong Jin Kim, Seung Ho Jung, Bong Yul Huh, Tai Woo Yoo, Hyo Yee Jeon, Hong Ji Song; J Korean Acad Fam Med 1997;18(3):271-283. Published online March 1, 1997

Abstract
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Background
: Recently in Europe, some epidemiologic studies reported that various physical symptoms and social, psychological wellbeing are related to low blood pressure. But in Korea, none has been studied on symptoms related to low blood pressure yet. In this study, we would like to see if the somatic symptoms and social, psychological wellbeing shown to be related to low SBP is truly associated with it.

Methods : Questionnaire interview was done to the people who have visited Department of family practice in two university hospitals and two health promotion center from April, 1996 to August, 1996. Seven somatic symptoms and Psychosocial Wellbeing Index(PWI) for the evaluation of social, psychological health status were included in the questionnaire. SAS statistics packages was used in statistical precess. We used logistic regression to see the frequency of somatic symptoms related to the systolic blood pressure(SBP) group and the confirmation of confounding variables was done by ANOVA.

Results : Total of 304 completed the questionnaire. Average age was 44 years old and average SBP was 115.4±16.4. 84of them(27.6%)felt that they had a low BP & 69 were women compared to 21 men, being meaningfully more common. 107(35.2%) people answered that they had heard that their blood pressure was low and 66% were from doctors. Only 32(38.1%) of the group who felt of having hypotensive symptoms and 38 of the group who heard of having hypotension actually had SBP of below 100mmHg. Vocation, income, smoking & alcohol history, present illness, marital status were not significant as a confounding variable. SBP of 100 or below group had a less presentation of fatigue & significantly higher PWI than the group of above 100mmHg(p<0.05). The group who felt that they had a low BP had more complaints fatigue, dizziness, palpitation, cold hands and feet and had significantly higher PWI than the group who didn't.

Conclusion : SBP of 100mmHg or below group has more frequent manifestion of fatigue and low level of sociopsycholgiacl health index than the above 100mmHg group. But most of the people who complained of hypotensive symptoms didn't have low blood pressure and a lot of them misunderstand of having low blood pressure and after checking blood pressure by doctors, so great deal of caution is called for when seeing patients.