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"Jae Yong Shim"

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"Jae Yong Shim"

Original Article

Background
Similar to smoking, exposure to secondhand smoke is a risk factor for developing hypertension and cardiovascular diseases; however, there is no standardized method for measuring smoke exposure. Measuring urine cotinine levels is one possible means for determining the degree of exposure to secondhand smoke. This study investigated the association between urinary cotinine levels and blood pressure in Korean adults exposed to secondhand smoke.
Methods
Data from the Korea National Health and Nutrition Examination Survey conducted between 2016 and 2018 were used. A total of 9,273 participants aged ≥19 years self-reported as current non-smokers, which was cotinine- verified. A complex sample general linear model regression analysis was performed to analyze the association between urine cotinine and blood pressure. A P-value of <0.05 was considered statistically significant.
Results
Corrected urine cotinine levels were positively associated with systolic and diastolic blood pressure in female participants (P<0.001 and P=0.040, respectively). Furthermore, a 10-fold increase in the corrected urine cotinine level of those in contact with secondhand smoke was independently associated with 2.085 mm Hg and 0.575 mm Hg increases in systolic and diastolic blood pressure, respectively. However, there was no association between systolic and diastolic blood pressure in male participants (P=0.226 and P=0.256, respectively).
Conclusion
Urinary cotinine levels were positively associated with increased blood pressure in females exposed to secondhand smoke. Therefore, urinary cotinine may be used as an indicator to quantify and monitor the effects of blood pressure elevation in females exposed to secondhand smoke.

Citations

Citations to this article as recorded by  
  • Association between the urine tobacco metabolite levels and physical health in Chinese primary school students with secondhand smoke exposure
    Menghan Cheng, Miao Zhang, Wen Fang, Hong Qin, Yue Pan, Shengyi Chen, Guiqi Cao, Yao Zhang, Yu Lu
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Assessment of smoking exposure by urine cotinine levels in severe COVID-19 patients: a case-control study
    Medeni Arpa, Bayram Şen, Leyla Kazancıoğlu, Hülya Kılıç
    Scientific Reports.2025;[Epub]     CrossRef
  • 5,146 View
  • 173 Download
  • 3 Web of Science
  • 2 Crossref

Clinical Practice Guideline

Clinical Practice Guidelines for Managing Frailty in Community-Dwelling Korean Elderly Adults in Primary Care Settings
Hyo-Sun You, Yu-Jin Kwon, Sunyoung Kim, Yang-Hyun Kim, Ye-seul Kim, Yonghwan Kim, Yong-kyun Roh, Byoungjin Park, Young Kyu Park, Chang-Hae Park, Joung Sik Son, Jinyoung Shin, Hyun-Young Shin, Bumjo Oh, Jae-woo Lee, Jae Yong Shim, Chang Won Won, Ji Won Yoo, Sang-Hyun Lee, Hee-Taik Kang, Duk Chul Lee
Korean J Fam Med 2021;42(6):413-424.   Published online November 20, 2021
DOI: https://doi.org/10.4082/kjfm.21.0162
Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.

Citations

Citations to this article as recorded by  
  • Promoting an international consensus on frailty assessment: An urgent call to address the challenges of perioperative management in an aging population
    Ying Xia, Wei Tang
    BioScience Trends.2026;[Epub]     CrossRef
  • International landscape of guidelines for perioperative frailty assessment and barriers to clinical translation
    Ya-nan Ma, Kenji Karako, Ying Xia, Peipei Song, Xiqi Hu
    BioScience Trends.2026;[Epub]     CrossRef
  • Effect of a wearable-sensor-assisted multicomponent exercise program on physical fitness, cognition and quality of life in frail older adults
    Genghong Tu, Lining Liu, Huiyi Tang, Weizhong Chen, Bagen Liao
    Translational Exercise Biomedicine.2025; 2(3): 201.     CrossRef
  • Frailty assessment utilization around the globe–a systematic review
    Samantha Gaston, Elle Billman, Lichy Han, David Drover
    The Journal of Frailty & Aging.2025; 14(6): 100088.     CrossRef
  • Exercise Prescription for Frail Older Adults: Impact on Handgrip Strength and Gait Speed – A Systematic Review
    Andreia Carvalho, Vânia Cerqueira Palma, Maria Teresa Tomás
    Physical & Occupational Therapy In Geriatrics.2025; : 1.     CrossRef
  • Summary of best evidence for prevention and management of frailty
    Yinning Guo, Xueyi Miao, Jieman Hu, Li Chen, Yimeng Chen, Kang Zhao, Ting Xu, Xiaoman Jiang, Hanfei Zhu, Xinyi Xu, Qin Xu
    Age and Ageing.2024;[Epub]     CrossRef
  • Frailty: Assessment and Intervention
    Hana Moon, Geon Ho Lee, DaeHyun Kim
    Keimyung Medical Journal.2024; 43(2): 100.     CrossRef
  • Clinical practice guidelines for frailty vary in quality but guide primary health care: a systematic review
    Huaxin Si, Jiaqi Yu, Qinqin Liu, Yanyan Li, Yaru Jin, Yanhui Bian, Xiaoxia Qiao, Wenyu Wang, Lili Ji, Yan Wang, Jian Du, Cuili Wang
    Journal of Clinical Epidemiology.2023; 161: 28.     CrossRef
  • Yaşlılarda Kırılganlığın Önlenmesi ve Yönetiminde Kanıta Dayalı Yaklaşımlar
    Ayşe Buket DOĞAN, Özlem CANBOLAT
    Sağlık Bilimlerinde Değer.2023; 13(3): 501.     CrossRef
  • Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults
    Jeong-Hyun Kang, Seong-Chan Park, Hoi-In Jung, Sun Jae Jung, Hye-Jin Park, Soo-Min Kim, Min-Ji Jo, Yun-Seon Lee, Sun-Young Han
    Epidemiology and Health.2023; 46: e2024008.     CrossRef
  • Up-to-date knowledge of frailty
    Chang Won Won
    Journal of the Korean Medical Association.2022; 65(2): 108.     CrossRef
  • Current status of nutrient intake in Korea: focused on macronutrients
    Seung-Won Oh
    Journal of the Korean Medical Association.2022; 65(12): 801.     CrossRef
  • 11,311 View
  • 217 Download
  • 8 Web of Science
  • 12 Crossref

Original Articles

Association between Salivary Mitochondrial DNA Copy Number and Chronic Fatigue according to Combined Symptoms in Korean Adults
Jinyoung Shin, Kyong Chol Kim, Duk Chul Lee, Hye Ree Lee, Jae Yong Shim
Korean J Fam Med 2017;38(4):206-212.   Published online July 20, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.4.206
Background

We examined the association between salivary mitochondrial DNA (mtDNA) copy number and chronic fatigue combined with depression and insomnia.

Methods

This cross-sectional study included 58 healthy adults with moderate to severe fatigue (Brief Fatigue Inventory [BFI] ≥4) for longer than 6 months. Subjects were classified as those without combined symptoms, with either depression (Beck Depression Inventory [BDI] ≥13) or insomnia (Pittsburgh Sleep Quality Index [PSQI] ≥5), or with both depression and insomnia. Salivary mtDNA copy number was measured by real-time quantitative polymerase chain reaction. The association was evaluated using a general linear model.

Results

About 76% of participants had either depression or insomnia as additional symptoms. These subjects were predominately female, drank more alcohol, and exercised less than those without combined symptoms (P<0.05). The group with both depression and insomnia exhibited significantly higher BFI and lower mtDNA copy number than those without combined symptoms (P<0.05). After adjusting for confounding factors, significant negative associations between mtDNA copy number and usual fatigue were found in the group without combined symptoms, whereas the negative associations in the group with combined symptoms were attenuated. BDI and PSQI were not associated with mtDNA copy number.

Conclusion

Chronic fatigue is negatively associated with salivary mtDNA copy number. Salivary mtDNA copy number may be a biological marker of fatigue with or without combined symptoms, indicating that a separate approach is necessary.

Citations

Citations to this article as recorded by  
  • Salivary mitochondrial DNA is associated with biomarkers of Alzheimer’s disease in cognitively normal older adults
    Jose L. Cantero, Mercedes Atienza, Petar Podlesniy, Margalida Puigròs, Ramon Trullas
    Translational Psychiatry.2025;[Epub]     CrossRef
  • Association of sleep quality and mitochondrial DNA copy number in healthy middle-aged adults
    Seolbin Han, Dae-Kwang Kim, Sang-Eun Jun, Nahyun Kim
    Sleep Medicine.2024; 113: 19.     CrossRef
  • The Association Between Periodontal Inflamed Surface Area (PISA), Inflammatory Biomarkers, and Mitochondrial DNA Copy Number
    Romana Mance Kristan, Staša Jurgec, Uroš Potočnik, Marko Marhl, Rok Gašperšič
    Journal of Clinical Medicine.2024; 14(1): 24.     CrossRef
  • Dual Effect of Combined Metformin and 2-Deoxy-D-Glucose Treatment on Mitochondrial Biogenesis and PD-L1 Expression in Triple-Negative Breast Cancer Cells
    Jernej Repas, Mateja Zupin, Maja Vodlan, Peter Veranič, Boris Gole, Uroš Potočnik, Mojca Pavlin
    Cancers.2022; 14(5): 1343.     CrossRef
  • Exosome‐associated mitochondrial DNA from patients with myalgic encephalomyelitis/chronic fatigue syndrome stimulates human microglia to release IL‐1β
    Irene Tsilioni, Benjamin Natelson, Theoharis C. Theoharides
    European Journal of Neuroscience.2022; 56(10): 5784.     CrossRef
  • Association of mitochondrial DNA content and displacement loop region sequence variations with cancer-related fatigue in breast cancer survivors receiving chemotherapy
    Yi Long Toh, Elgenia Wong, Jung-Woo Chae, Ning Yi Yap, Angie Hui Ling Yeo, Maung Shwe, Alexandre Chan
    Mitochondrion.2020; 54: 65.     CrossRef
  • Development of the MitoQ assay as a real-time quantification of mitochondrial DNA in degraded samples
    Ka Tak Wai, Peter Gunn, Mark Barash
    International Journal of Legal Medicine.2019; 133(2): 411.     CrossRef
  • Mitochondrial DNA methylation and copy number predict body composition in a young female population
    Laura Bordoni, Vanessa Smerilli, Cinzia Nasuti, Rosita Gabbianelli
    Journal of Translational Medicine.2019;[Epub]     CrossRef
  • 6,745 View
  • 33 Download
  • 9 Web of Science
  • 8 Crossref
Relationship between Blood Mercury Concentration and Bone Mineral Density in Korean Men in the 2008–2010 Korean National Health and Nutrition Examination Survey
Yang Hee Kim, Jae Yong Shim, Min Seok Seo, Hyung Ji Yim, Mi Ra Cho
Korean J Fam Med 2016;37(5):273-278.   Published online September 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.5.273
Background

The results of previous studies on the association between blood mercury (Hg) and bone mineral density (BMD) are inconsistent. We therefore used a large-scale nationwide representative sample of Korean men to investigate the relationship between these two parameters.

Methods

A nationwide cross-sectional study was conducted using data from the 2008 to 2010 Korean National Health and Nutrition Examination Survey to evaluate the relationship between blood Hg and BMD and the prevalence of osteopenia or osteoporosis in 1,190 men over 50 years of age. BMD was measured by dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed for each body site according to World Health Organization T-score criteria.

Results

After adjusting for age, body mass index, caloric energy and calcium intake, vitamin D levels, fish consumption, alcohol consumption, smoking, and exercise, quartiles of blood Hg were positively associated with femur neck T-scores in multiple linear regression analysis (β=0.06, P-value=0.03). Compared with the lowest blood Hg quartile, the odds ratios and 95% confidence intervals for diagnosis of osteopenia or osteoporosis in the second and fourth quartiles were 0.63 (0.41–0.99) and 0.57 (0.36–0.91), respectively, in the femur neck after adjusting for the same co-variables.

Conclusion

High blood Hg levels were associated with reduced odds of decreased femur neck BMD in Korean men. However, subgroup analysis did not show a significant protective effect of blood Hg on osteoporotic fractures. Further research is necessary to clarify the association between blood Hg and BMD.

Citations

Citations to this article as recorded by  
  • Associations between multiple metals exposure and bone mineral density: a population-based study in U.S. children and adolescents
    Jian Han, Jiaqing Sun, Lin Yuan, Luyao Lou, Xiaofeng Jiang
    BMC Musculoskeletal Disorders.2025;[Epub]     CrossRef
  • Metallic Contaminants and Osteoporosis: a Review of the Gut-Bone Axis
    Yongjie Yang, Shuqi Yuan, Tianbao Gong, Jiaxiang Zhang, Haitao Ma, Defu Yu, Tao Chen
    Biological Trace Element Research.2025;[Epub]     CrossRef
  • Metals accumulation affects bone and muscle in osteoporotic patients: A pilot study
    Beatrice Battistini, Chiara Greggi, Virginia Veronica Visconti, Marco Albanese, Alessandra Messina, Patrizia De Filippis, Beatrice Gasperini, Angela Falvino, Prisco Piscitelli, Leonardo Palombi, Umberto Tarantino
    Environmental Research.2024; 250: 118514.     CrossRef
  • Trends in the prevalence of osteoporosis and effects of heavy metal exposure using interpretable machine learning
    Hewei Xiao, Xueyan Liang, Huijuan Li, Xiaoyu Chen, Yan Li
    Ecotoxicology and Environmental Safety.2024; 286: 117238.     CrossRef
  • Association of blood mercury levels with bone mineral density in adolescents aged 12–19
    Ke Xu, Bingqian Gao, Tingfeng Liu, Jiayi Li, Yixin Xiang, Yicheng Fu, Mingyi Zhao
    Environmental Science and Pollution Research.2023; 30(16): 46933.     CrossRef
  • Relationship of blood heavy metals and osteoporosis among the middle-aged and elderly adults: A secondary analysis from NHANES 2013 to 2014 and 2017 to 2018
    Zengfa Huang, Xiang Wang, Hui Wang, Shutong Zhang, Xinyu Du, Hui Wei
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Associations of blood trace elements with bone mineral density: a population-based study in US adults
    Chunli Wu, Yao Xiao, Yuexia Jiang
    Journal of Orthopaedic Surgery and Research.2023;[Epub]     CrossRef
  • Normal concentration range of blood mercury and bone mineral density: a cross-sectional study of National Health and Nutrition Examination Survey (NHANES) 2005–2010
    Yuchen Tang, Qiong Yi, Shenghong Wang, Yayi Xia, Bin Geng
    Environmental Science and Pollution Research.2022; 29(5): 7743.     CrossRef
  • Associations of multiple metals with bone mineral density: A population-based study in US adults
    Mu-hong Wei, Yuan Cui, Hao-long Zhou, Wen-jing Song, Dong-sheng Di, Ru-yi Zhang, Qin Huang, Jun-an Liu, Qi Wang
    Chemosphere.2021; 282: 131150.     CrossRef
  • Occurrence of mercury in the knee joint tissues
    Magdalena Babuśka-Roczniak, Barbara Brodziak-Dopierała, Joanna Bem, Anna Kruczek, Elżbieta Cipora, Wojciech Roczniak
    Polish Annals of Medicine.2021;[Epub]     CrossRef
  • Exposure to heavy metals and the risk of osteopenia or osteoporosis: a systematic review and meta-analysis
    C. Jalili, M. Kazemi, E. Taheri, H. Mohammadi, B. Boozari, A. Hadi, S. Moradi
    Osteoporosis International.2020; 31(9): 1671.     CrossRef
  • Relationship between heavy metal accumulation and histological alterations in voles from alpine and forest habitats of the West Carpathians
    Zuzana Kompišová Ballová, Filip Korec, Katarína Pinterová
    Environmental Science and Pollution Research.2020; 27(29): 36411.     CrossRef
  • Long-Term Accumulation of Metals in the Skeleton as Related to Osteoporotic Derangements
    Geir Bjørklund, Lyudmila Pivina, Maryam Dadar, Yuliya Semenova, Salvatore Chirumbolo, Jan Aaseth
    Current Medicinal Chemistry.2020; 27(40): 6837.     CrossRef
  • 5,734 View
  • 32 Download
  • 12 Web of Science
  • 13 Crossref
High-normal Glucose Levels in Non-diabetic and Pre-diabetic Men Are Associated with Decreased Testosterone Levels
Jin Young Shin, Eun Ki Park, Byoung Jin Park, Jae Yong Shim, Hye Ree Lee
Korean J Fam Med 2012;33(3):152-156.   Published online May 24, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.3.152
Background

Testosterone levels are decreased in diabetic patients and recent studies have suggested that high-normal fasting glucose is a risk factor for cardiovascular disease. To further elucidate the relationship between plasma glucose and testosterone, we investigated the association between fasting plasma glucose (FPG) and endogenous sex hormones (serum total testosterone, sex hormone binding globulin, estradiol, and the ratio of testosterone to estradiol) in non-diabetic and pre-diabetic men.

Methods

This study included 388 men (age ≥ 40 years) who visited the health promotion center of a university hospital from May 2007 to August 2008. The subjects were divided into quartiles based on their FPG levels and correlation and multiple linear regression analyses were performed. Q1 (65 mg/dL ≤ FPG < 88 mg/dL), Q2 (88 mg/dL ≤ FPG < 94 mg/dL), Q3 (94 mg/dL ≤ FPG < 100 mg/dL) and Q4 (100 mg/dL ≤ FPG < 126 mg/dL).

Results

FPG was independently, inversely associated with total testosterone in the non-diabetic population after adjusting for age, body mass index, smoking, and alcohol consumption (β = -0.082, P < 0.01). Among the quartiles, subjects in the high-normal FPG groups (Q2, Q3, and Q4 with FPG ≥ 88 mg/dL) had significantly decreased testosterone levels when compared with subjects in the normal FPG group (Q1 with FPG < 88 mg/dL, P < 0.005). Sex hormone binding globulin, estradiol and the ratio of testosterone to estradiol were not correlated with FPG.

Conclusion

Our study indicates that high-normal fasting glucose levels are associated with decreased testosterone levels in non-diabetic and pre-diabetic men.

Citations

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  • Effects of diabetes mellitus on sperm quality and fertility outcomes: Clinical evidence
    Francesco Lotti, Mario Maggi
    Andrology.2023; 11(2): 399.     CrossRef
  • Upcoming Aging Society and Men's Health: Focus on Clinical Implications of Exercise and Lifestyle Modification
    Byoungjin Park, Yong-Jae Lee
    The World Journal of Men's Health.2020; 38(1): 24.     CrossRef
  • A cross-sectional study on the associations of insulin resistance with sex hormone, abnormal lipid metabolism in T2DM and IGT patients
    Xiaoxia Wang, Tongzhang Xian, Xiaofan Jia, Lina Zhang, Li Liu, Fuli Man, Xianbo Zhang, Jie Zhang, Qi Pan, Lixin Guo
    Medicine.2017; 96(26): e7378.     CrossRef
  • Pre‐diabetes and serum sex steroid hormones among US men
    R. Arthur, S. Rohrmann, H. Møller, E. Selvin, A. S. Dobs, N. Kanarek, W. Nelson, E. A. Platz, M. Van Hemelrijck
    Andrology.2017; 5(1): 49.     CrossRef
  • Testosterone and type 2 diabetes in men
    Allan Mazur, Ronny Westerman, Andrea Werdecker, Ulrich Mueller
    The Aging Male.2014; 17(1): 18.     CrossRef
  • 5,010 View
  • 35 Download
  • 5 Crossref
Sleep Quality of Breast Cancer Patients Receiving Chemotherapy in the Outpatients Setting.
Joo Hyun Park, Sun Jin Lee, Jung Im Gwak, Jae Yong Shim, Jung Kwon Lee
Korean J Fam Med 2010;31(10):778-785.   Published online October 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.10.778
Background
Breast cancer is the second most common cancer in Korean women. As survival years increase, health-related quality of life has become an important issue in breast cancer patients. Sleep problems are common and cause significant disruption in quality of life in breast cancer patients. However, cancer-related sleep disturbance has received little attention. The purpose of this study was to determine the prevalence of poor sleep quality and factors which are associated with poor sleep quality in the breast cancer patients receiving chemotherapy in the outpatients setting. Methods: One hundred and twenty-seven breast cancer patients receiving chemotherapy in a tertiary hospital outpatient were surveyed between February 2009 and July 2009. Among them, 94 (72.8%) patients were finally included in the study. The sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI). PSQI > 5 indicates clinically significant poor sleep quality. Also the independent factors of sleep quality were assessed using univariable analysis and multiple logistic regression analysis. Results: Seventy-two (76.6%) patients of 94 breast cancer patients undergoing chemotherapy have poor sleep quality. Among of them, 11 (15.3%) patients were actually consulted with doctors. Average PSQI score was 8.8 (± 4.1). Anxiety and employment status were associated with poor sleep quality. Conclusion: A high proportion of breast cancer patients receiving chemotherapy even in the outpatient settings had poor sleep quality. But only small proportion of them consulted doctor. Poor sleep quality during chemotherapy in breast cancer patient was associated with anxiety and employment status. Considering the high prevalence of sleep problem and inadequate management, more adequate attention is needed to manage the sleep problem of breast cancer patients receiving chemotherapy.

Citations

Citations to this article as recorded by  
  • Psychometric Evaluation of the Pittsburgh Sleep Quality Index in Korean Breast Cancer Survivors: A Confirmatory Factor Analysis
    Mi Jung, Moonkyoung Park, Kyeongin Cha, Xirong Cui, Ah Lee, Jeongeun Hwang
    Healthcare.2025; 13(19): 2481.     CrossRef
  • The Influence of Depression, Sleep Quality, and Mental Health Literacy on the Quality of Life in Breast Cancer Patients
    Minjin Kim, Suin Park
    Asian Oncology Nursing.2024; 24(2): 73.     CrossRef
  • Validity Analysis of Neck Circumference as a Screening Test for Hypoxia Occurrence in Patients Undergoing Sedative Endoscopy
    Hyun-Ji Song, Jiyun Kim
    Healthcare.2022; 10(4): 679.     CrossRef
  • Sleep Quality and Associated Factors Among Adult Cancer Patients Under Treatment at Oncology Units in Amhara Region, Ethiopia
    Destaw Endeshaw, Henok Biresaw, Tseganesh Asefa, Nurhusien Nuru Yesuf, Senay Yohannes
    Nature and Science of Sleep.2022; Volume 14: 1049.     CrossRef
  • Sleep Quality and Cancer-Related Fatigue in Patients with Cancer
    Mahdieh Momayyezi, Hossein Fallahzadeh, Fatemeh Farzaneh, Mohammad Momayyezi
    Journal of Caring Sciences.2021; 10(3): 145.     CrossRef
  • Factors Influencing Quality of Sleep among Patients with Colorectal Cancer Receiving Chemotherapy
    Hee Soon Jang, Eun Ok Choi
    Asian Oncology Nursing.2016; 16(2): 103.     CrossRef
  • A Symptom Cluster Analysis of Breast Cancer Patients Using a Mediation Model
    Gyung Duck Kim, Hyun Jin Jang
    Asian Oncology Nursing.2012; 12(4): 274.     CrossRef
  • Related Factors to Quality of Life among Hospitalized Cancer Patients Undergoing Chemotherapy
    Ji Yeon Jeong, Hyang Sook So, Ji Eun Hong, Myeong Jeong Chae, Geunhye Han
    Asian Oncology Nursing.2012; 12(1): 84.     CrossRef
  • 3,848 View
  • 45 Download
  • 8 Crossref
Relationship between Metabolic Syndrome and QTc Interval Prolongation.
Kwang Shik Park, Min Seok Seo, Wan Je Cho, Jung Hyun Lee, Hye Ree Lee, Jae Yong Shim
Korean J Fam Med 2010;31(4):267-274.   Published online April 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.4.267
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.

Citations

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  • Influence and the underlying mechanisms of substrate type on the growth of razor clam Sinonovacula constricta
    Zhanfeng Liang, Jilin Xu, Shuonan Ma, Chunpu Zhao, Ying Zeng, Anhao Wang, Wenhao Yin, Kai Liao
    Aquacultural Engineering.2025; 111: 102549.     CrossRef
  • Resting Heart Rate, QTc Interval, and Laboratory Variables in Relation to Risk Factors of Metabolic Syndrome in Korean Adult Male
    Chul-Gyu Kim, Sun Kyung Cha
    Journal of Health Informatics and Statistics.2017; 42(4): 322.     CrossRef
  • 2,934 View
  • 18 Download
  • 2 Crossref
Relationship of Serum Homocysteine with Brachial-Ankle Pulse Wave Velocity in Middle Aged Women.
Byoung Jin Park, Hye Yun Chun, Ah Reum Han, Ji Ae Lim, Duk Chul Lee, Jae Yong Shim, Hye Ree Lee
Korean J Fam Med 2009;30(6):457-463.   Published online June 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.6.457
Background
Several studies showed the relationship between serum homocysteine and pulse wave velocity, but their subjects were confi ned to high risk group for cardiovascular diseases and recent study revealed no relationship in young healthy adults. We hypothesized that time interval would be needed for serum homocysteine to infl uence pulse wave velocity after exposure to vascular endothelium. The purpose of this study was to determine the relationship between serum homocysteine and pulse wave velocity in middle aged women on the basis of that hypothesis and necessity for further study in general population.Methods: The study subjects were 110 middle aged women who visited a health promotion center of a general hospital. We collected medical history by means of self-reported questionnaire and measured height, weight, blood pressure and brachial-ankle pulse wave velocity (baPWV). Blood sampling was performed after overnight fasting. We analyzed the relationship between several cardiovascular risk factors and baPWV and performed multiple regression analysis.Results: BaPWV velocity was correlated signifi cantly with age, mean blood pressure, serum homocysteine, total cholesterol and diabetes mellitus, but not with body mass index, high-density lipoprotein cholesterol, triglyceride, creatinine clearance, alcohol intake, hypertension and smoking. In multiple regression, there was a signifi cant association between age (P = 0.04), moderate hyperhomocysteinemia (P = 0.02), mean blood pressure (P < 0.001) and baPWV.Conclusion: In middle aged women, there was an independently positive association between serum homocysteine and baPWV.

Citations

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  • Borderline-High Mean Corpuscular Volume Levels Are Associated with Arterial Stiffness among the Apparently Healthy Korean Individuals
    Haneul Kwon, Byoungjin Park
    Korean Journal of Family Medicine.2020; 41(6): 387.     CrossRef
  • 2,578 View
  • 16 Download
  • 1 Crossref
Relationship between the Metabolic Syndrome and Cognitive Function.
Sang Hoon Moon, Hyun Ju Oh, Sang Hwan Kim, Hye Ree Lee, Duk Chul Lee, Jae Yong Shim
J Korean Acad Fam Med 2006;27(6):463-470.   Published online June 10, 2006
Background
: Several studies have revealed a relationship between the cognitive decline and several cardiovascular diseases. The relationship between the metabolic syndrome and cognitive function has not been studied yet in Korea. The objective of our study was to determine the relationship between the metabolic syndrome and cognitive function in elders above 50 years old.

Methods : We examined subjects who visited the health promotion center of one college hospital in Seoul. The metabolic syndrome was defined according to the National Cholesterol Education Program guidelines and we categorized the two groups by the presence of the metabolic syndrome. We used the Korean version of Mini Mental State Examination to check the cognitive functions and compared scores between these two groups.

Results : There were a total of 400 subjects (195 men and 205 women). Compared with those without the metabolic syndrome, elders with the metabolic syndrome had lower mean scores in K-MMSE (26.6±2.0-28.2±1.8, P<0.001). In subcategories of K-MMSE, the average scores of concentration or calculation were lower in the metabolic syndrome group (3.5±1.3) than in the control group (4.3±1.0) and the average scores of delayed recall were lower in those with the metabolic syndrome (1.7±0.9) than the control group (2.2±0.8) (P<0.001). After controlling for age, sex, education, smoking, alcohol, and body mass index, multiple regression yielded the metabolic syndrome to be independent associated factor in cognitive function (P<0.001).

Conclusion : We found a significant relationship between decreased cognitive function and the metabolic syndrome. There are needs for prospective study about the possible development of dementia in the metabolic syndrome and probable prevention of dementia when cardiovascular risk factors in those are modulated.
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Acute Reduction of Pulse Wave Velocity after Sauna in Adults in a Community.
Moo Young Kim, Shin Jung Oh, Ah Reum Han, Hye Ree Lee, Jae Yong Shim, Duk Chul Lee
J Korean Acad Fam Med 2006;27(5):384-390.   Published online May 10, 2006
Background
: Recently, thermal therapy such as sauna and sweating room is popular as a health behavior. In patients with heart failure, sauna treatment improves hemodynamic data and clinical symptoms by restoring endothelial function. The purpose of this study was to investigate that sauna bath could decrease pulse wave velocity reflecting vascular function of people in the community.

Methods : A total of 43 volunteers (11 male, 32 female) older than 40 years old were kept in 60℃ dry sauna for 15 to 20 minutes. We measured the brachial-ankle pulse wave velocity (baPWV), blood pressure, heart rate, body weight and body temperature before and, 30 and 60 minutes after sauna bath and assessed the differences of the means of these measurements with repeated measures of ANOVA. Then, we performed multiple regression analysis to find out the factors independently associated with the amount of baPWV change.

Results : The BaPWV and systolic and diastolic blood pressure decreased significantly 30 and 60 minutes after sauna bath comparing to those before (P<0.001, P=0.003, P=0.011, respectively). Multiple regression analysis showed that baseline baPWV and history of hypercholesterolemia independently influenced on the amount of baPWV change (β=-0.47, P=0.002; β=-0.36, P=0.013, respectively).

Conclusion : We studied the acute reduction of pulse wave velocity after sauna bath in adults over 40 years old. This change was striking in the subjects with faster baseline baPWV. This result suggests that sauna bath can improve vascular function in the high risk group of cardiovascular diseases.
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The Relationship between Heart Rate Variability and Illness Severity.
Sang Hwan Kim, Hee Jin Hwang, Jae Won Kim, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2005;26(3):152-157.   Published online March 10, 2005
Background
: In severity of illness index, there is an acute physiologic and chronic health evaluation (APACHE) scoring system which was modified to APACHE III in 1990. Heart rate variability (HRV) studies for the intensive care unit (ICU) patients provides an indirect but noninvasive probe of autonomic cardiovascular control. Therefore, we intended to find out the relationship between the APACHE III score and the HRV variables in ICU patients.

Methods : We examined 22 patients in medical ICU of one college hospital from April to May of 2003, excluding patients with cardiac disorders, neurologic disorders or surgical diseases. We also examined 22 patients in general wards of family medicine. We checked the APACHE III during the 24 hours of admission, and examined the HRV on the second day of admission and then the total power (TP), normalized low frequency (LFnorm), low frequency/ high frequency ratio (LF/HF ratio) and approximate entropy (ApEn).

Results : The average of TP (msec2) were 538.9±896.7 in ICU patients and 1605.3±3091.8 in patients of general ward. The average APACHE III score was 35.9±18.5 and by Pearson correlation analysis, the correlation coefficient between the APACHE III score and the log (TP) was -0.58 (P=0.005).

Conclusion : We found that the medical ICU patients had more decreased autonomic function than the patients of general ward, and there was a negative correlation with the APACHE III score and the disease severity.
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Research and Scholarly Activity of Residency Programs of Family Medicine in Korea.
Sung Hee Lee, Yu Jin Paek, Soo Young Kim, Sang Woo Oh, Jae Yong Shim, Jung Kwon Lee
J Korean Acad Fam Med 2004;25(11):826-834.   Published online November 10, 2004
Background
: This study was conducted to survey current status of research and scholarly activity of residency programs and to evaluate quality of education.

Methods : Questionnaire on research and scholarly activity were sent to all residency training programs by regular mail on May 2003. The questionnaire included detailed characteristics of residency programs, current status of conferences, educations for research activities, degree of faculty involvement, and numbers of published papers and presentations for past year.

Results : A total of 103 residency programs answered the questionnaire. Most of the programs held journal review, book review, and clinical review in regular bases as scholarly activities. Smaller than 50% of the programs held case review, chart review, and psycho- social conference in regular bases. As research activity, 40 programs offered educations on epidemiology and statistics, and 55 programs held critical review of the literatures. Faculties involve actively in residents' research project in the process of designing research questions and selecting the subjects, but less actively in the process of gathering informations, completing manuscripts, and preparing presentations. Degrees of faculty involvement were smaller in the programs which are connected with medical school, had only 1 faculty, and educational experiences of the faculty were insufficient.

Conclusion : Current scholarly activities were active in various aspects, but psychosocial conference and chart audit should be encouraged. Special efforts are required in the research activities, especially in programs which were not connected with medical school and had only one faculty.
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Heart Rate Variability in Metabolic Syndrome.
Yong Jae Lee, Mun Sung Kim, Bum Taek Kim, Tae Hwan Kwak, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2002;23(12):1432-1439.   Published online December 10, 2002
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What do Korean people think of family doctor registration program?.
Hong Jun Cho, Jae Yong Shim, Hye Ree Lee, Sun Hee Lee
J Korean Acad Fam Med 2002;23(2):171-178.   Published online February 1, 2002
Background
: Family doctor registration program was proposed several years ago and is still in discussion. The success of this program depends on attitude and acceptibility of people. This study was done to describe the attitudes of the people to the family doctor registration program.

Methods : We interviewed 657 adults who lived in Seoul, Bundang, Ilsan and Pyungchon with a preformed questionnaire. The questionnaire was pretested by five family doctor and trainee.

Results : About half of the respondents were favorable for family doctor registration program. The most importantly considered benefits of the program were continuity of care, telephone consultation and management of chronic disease. The most seriously considered drawbacks of the program were only single doctor available cost, and restriction of medical services. Over half of the respondents preferred internists as their treating doctor and family physician, pediatrician followed. About half of the respondents opposed on the fact that the family doctor was restricted to clinic-based practice. Half of the respondents intended to participate in the program and the rate of intention to participate in the family doctor registration program was related to their household income and favorable attitude to wards the program and marginally related to the number in a household, haring a regular doctor, their interest in health. The demographic variables did not influence intention to participate in the program.

Conclusion : Half of the respondents agreed to participate in the family doctor registration program, but others were negative to the principles of the program and cost, sharing.
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Factors associated with possession of regular doctor in Korea.
Hong Jun Cho, Jae Yong Shim, Hye Ree Lee, Sun Hee Lee
J Korean Acad Fam Med 2001;22(11):1612-1621.   Published online November 1, 2001
Background
: As patients can go to specialists and family doctors do not have gate-keeping role, doctor-shopping is very popular in Korea. The introduction of family doctor registration program is proposed several years ago, and the debate is still being done about that issue. This study is to show the possession rate of regular doctor and to investigate the factors associated with it.

Methods : We interviewed 657 adults of Seoul, Bundang, Ilsan and Pyungchon with preformed questionnaire which included the questions about regular doctor and attitudes to the family doctor registration program. Respondents were sampled according to the age structure and population distribution of the cities.

Results : About half of the respondents had regular doctor. Internists were regular doctors of nearly half of the respondents and pediatricians 30.6%, oriental doctors 5.6%, general surgeon 4.4%, and family doctors 3.8%. About half of the regular doctors worked in primary clinic and 48.2% in hospitals. The most important reason choosing regular doctor was distance to the medical facilities. The most frequently provided service by regular doctor was vaccination (57.1%), the least was home visit (2.9%). Factors associated with the possession of regular doctors were residence area, sex of respondents, level of income and education.

Conclusion : Nearly half of the respondents had regular doctors and half of the regular doctors were internists and worked in primary clinics. The area of residence, sex, income level, level of education, and interest for health were related with the possession of regular doctor.
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Reasons of delay of hospital presentation in patients with acute stroke.
So Yeon Kim, Tai Hyeong Ryeom, Young Eun Choi, Hang Suk Cho, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2001;22(10):1511-1519.   Published online October 1, 2001
Background
: Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time dependent. Patients with acute stroke often arrive at the hospital too late to receive the maximum benefit from these new stroke therapies. Efforts to reduce delay time of therapy for acute stroke may be more effective if the factors that delay hospital arrival are identified and targeted for specific intervention. So we studied about reason of delay of hospital presentation in patients with acute stroke.

Methods : The 85 acute stroke patients group who admitted to the Young-dong severance hospital from April to August 1999 were enrolled in this study. We collected clinical data from the medical record, including demographic characteristics, date and time of symptom onset, date and time of presentation to the hospital, medical history, and symptoms at stroke onset. And informants about stroke, method of transportation, the patient's interpretation of the symptoms were interviewed. We defined early arrival as within 3 hours of awareness of symptoms.

Results : The 85 patients were interviewed, early arrival were more likely to arrive by ambulance (P<0.001), admit via emergency department(p=0.001), interpret their symptoms as a stroke(P=0.005) and use readings as a informants about stroke(P=0.027) than late arrivals. Also they were younger than late arrivals(P=0.027). Main reason of delay of hospital presentation was because they expect spontaneous improvement(43%), mistake as other disease(23.3%), arrive via other medical institute(20%).

Conclusion : Late arrivals expected spontaneous improvement, misinterpreted their symptoms as those of other disease and didn't choose proper medical institute for acute management. Considerable education is needed to increase the knowledge about stroke and proper acute management.
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Attitudes of medical students and housestaff toward euthanasia.
Joo Tae Kim, Kyung Chul Kim, Dong Hyeok Shin, Hang Suk Cho, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2001;22(10):1494-1502.   Published online October 1, 2001
Background
: Medical decisions concerning the prolongation of life. the right to die and euthanasia are among the most extensively discussed issues within medicine and law today. The purpose of this study was to evaluate the attitudes of medical of students and housestaff toward euthanasia.

Methods : From July 15 to september 15 of the 1998, the responses of 180 medical students and 132 housestaff to a self-adbministered questionnaire were analyzed to identify attitudes toward euthanasia. Over 312 respondents about attitudes toward euthanasia, the analysis of differences between proportions was made by the Chi-square test.

Results : About 69.9% of the respondents thought euthanasia should be legalized. The findings suggest that Buddhists (77.5%) and non-religious groups (88.1%) tend to support euthanasia more than Christians. Futhermore, medical students (74.4%) support euthanasia more than housestaffs(63.6%), male(75.1%) more often than female(57.9%). about 73.1% of the respondents said that active euthanasia is not justifiable, and 79.2% said that they do not like performing active euthanasia. In respect to passive euthanasia, 69.0% said that it is not ethically justifiable, but 63.0% would perform this as if it were legal. Housestaffs of internal medicine (76.9%) were more willing to do euthanasia than pediatrics (70.0%), surgery (63.6%), family practice (53.8%) and Ob/Gyn(33.3%).

Conclusion : Respondents have positive attitudes toward legalization of euthanasia.. Most considered that passive euthanasia is not morally justifiable. But if it were legalized, they would still be disturbed by active euthanasia. The opinions of physician and medical students directly affect patient care and their attitudes must be considered if clear plicies are to be developed concerning euthanasia.
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Reliability and validity of Korean templer's death anxiety scale, death depression scale and sense of symbolic immortality scale.
Mi Ryung An, Ye Kyung So, Byung Su Ko, Young Eun Choi, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2000;21(7):893-900.   Published online July 1, 2000
Background
: Means to measure death anxiety, death depression and sense of symbolic immortality with approved validity and reliability does not yet exist in Korea.

Methods : Existing English questionnaires such as Templer Death Anxiety Scale (TDAS), Death Depression Scale (DDS), Sense of Symbolic Immortaligy Scale (SSIS) were translated into Korean by 5 translators, and then reviewed by 3 non-participants of translation for collegial summary and this summary was counter-translated again by another 2 non-participants. Another 3 non-participants of translation and counter-translation were chosen to examine the two sentences of each item. Then reexamination was done by retranslating and counter-translating the parts with errors. After pretest on ordinary people. The completed questionnaires were given to medical students, residents and nurses of a university hospital. Pastors and missionaries were selected as comparison group.

Results : Kuder-Richardson or Cronbach-α that represent internal consistency of TDAS, DDS and SSIs was 0.69, 0.84 and 0.78. The three sentences that lowered internal consistency of SSIS was deleted. BDI and DDS showed a positive correlation (0.32, P=0.02), suggesting proved construct validity. Correlation coefficient that proves construct validity of TDAS and DDS was 0.54 (P<0.01), of SSIS and TDAS -0.23(P=0.04), of SSIS and DDS -0.29(P=0.01). The TDAS and DDS(P<0.01), DDS and BDI(P=0.02) have shown a positive correlation were shown. There was significant difference in the score of SSIS(P<0.01). The same results in cases where the 3 sentences was deleted.

Conclusion : Korean versions of TDAS, DDS and SSIS were reliable and valid.
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FACES III in the Korean adolescents.
Byung Su Ko, Woo Su Shim, Yun Ju Kang, Jae Yong Shim, Hye Ree Lee, Dong Hyun Ahn
J Korean Acad Fam Med 2000;21(5):615-624.   Published online May 1, 2000
Background
: This study was intended to look into the characteristics and problems when FACES III are used as tools to evaluate family function of adolescents.

Methods : From May to June1996, self-reported questionnaires for FACES III were conducted on 2,430 middle school and high school students(males:1,190, female:1,240) in Seoul and Yangpyung, Kyunggi-Do. There were eight schools(four middle school, four high school) in Seoul and two schools(one middle school, one high school) in Yangpyung, Kyunggi-Do in this study. Also, education level of parents, occupational status of parents, family types(extended/nuclear), number of family member and numbers of siblings were assessed.

Results : The mean values of adaptability were significantly higher in Seoul students, in females, and in nuclear families. The mean values were higher in single sibling than two or more and in parents with higher education. The mean values of cohesion were significantly higher in Seoul students, in middle school students and in family members of 5 and under. The mean values were higher in those without a sibiling and in those with above college education. In stepwise regression analysis, educational level of parents, gender, area, occupational status of mother and grade were associated significantly with the mean values of adaptability and educational level of mother and grade were associated significantly with the mean values of adaptability and educational level of parents, grade and numbers of siblings were significantly associated with the mean values of cohesion.

Conclusion : We consider that there are problems in deciding the cut-off point and in the questionnaires of survey when the FACES III is used as a tool for evaluating family function of adolescents. Trials of combining other tools of family function or consideration of lower concepts are needed in other to be applicable to the individual conversation and clinical surroundings.
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Attitude of cancer patients, their primary care givers and doctors toward end-of-life care.
Jae Yong Shim, Youn Seon Choi, Yong Joon Kang, Hyun Sang Cho, Hang Suk Cho
J Korean Acad Fam Med 2000;21(4):489-497.   Published online April 1, 2000
Background
: Decision about life sustaining treatments ought to be based on the patient’s in formed preferences. This study was to see if there were any differences in acceptance by patients, their primary care givers and doctors for end-of-life care according to situations, and if any, to analyse the factors related with different attitudes.

Methods : A structured questionnaire survey of end-of-life care preferences was performed on 162 cancer patients and their primary care givers in four university hospitals and one general hospital from March 1, 1999 to February 29, 2000. A similar survey was done for doctors practicing at the above, hospitals during the same period to investigate their attitudes toward providing end-of-life care to an assumed nearly bed ridden patients. ANOVA, t-test and Wilcoxon rank sum test were used to compare acceptance of intervention among the groups or according to the various situations. Factors presumed to be related to the acceptance were sought and analysed by stepwise multiple regression.

Results : The difference in acceptance of intervention between the primary care giver group and the doctor group was not significant in almost every situation, showing significantly higher than the patient group(P=0.001). All three groups showed higher acceptance when a therapeutic intervention rather than a diagnostic test was proposed(P=0.001). When expected survival was 30 days rather than 7 (P=0.01), and when the therapeutic intervention was thought as non-invasive rather than invasive (P=0.001). The less anxious the patient was , the higher the acceptance. From the patient. Patients with a religion had higher acceptance rate than non-religious patients. Primary care givers who expected sure of the disease accepted more of the postulated care than those who did not (P<0.05). Wives of mother-in-laws of patients showed lower acceptance than those in other relationship(P<0.05). The longer the patient had been diagnosed with cancer, the higher the acceptance of the primary care giver (P<0.1). Direct relatives showed higher acceptance than that of collaterals(P<0.01). Family doctors specializing in family medicine had lower acceptance than doctors of other specialties and interns(P<0.05)

Conclusion : The acceptance of intervention by patients was lower than that of primary care givers and doctors and depended on the expected survival and the type, of intervention.
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The Development of Korean Health Related Quality of Life Scale (KQUOLS): Testing Reliability and Validity.
Soo Young Kim, Jae Yong Shim, Won Jang Won, Woo Sung Sun, Hoon Ki Park, Jung kwon Lee
J Korean Acad Fam Med 2000;21(3):382-394.   Published online March 1, 2000
Background
: Korean health related Quality of Life Scale(KQOLS) was developed to measure the quality of life reflecting Korean’s own language expression and culture. In order to confide in the results of KQOLS, it is necessary to establish verification of the psychometric properties(reliability, validity, responsiveness).

Methods : KQOLS’s final 46 items and item option responses were established by expert panels. Reliability was tested by 2 weeks test-retest method and internal consistency methods. Validity was tested by factor analysis and clinical validity. Sensitivity and specificity for detecting treatment-related changes were also tested.

Results : A high degree of internal consistency was observed for each of domains(Cronbach’s alpha value of 0.77 or higher). Two weeks test-retest reliability correlation coefficients scores were highly significant except health perception domain. A principal components analysis identified 9 factors with eight values greater than 1.0 which were approximately the same as intended domains. Normal control group had statistically significant higher scores than patients group except in spiritual health and social function domains. Improved group of patients had statistically significant higher scores than non-improve group of patients after treatment except in spiritual health and health status perception domains.

Conclusion : Korean health related Quality of Life Scale(KQOLS) is both a valid and a reliable instrument, but fine refinements such as items revision and item response options modification will be needed.
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The comparison of the medical costs and quality of life in terminal cancer patients by the types of medical facilities.
Chang Hwan Yeom, Youn Seon Choi, Hye Ree Lee, Jae Yong Shim, Young Seon Hong, Wha Sook Choe, Young Ran Park
J Korean Acad Fam Med 2000;21(3):332-343.   Published online March 1, 2000
Background
: Life expectancy is ever increasing due to medical advancements, but cancer death rate is also increased. Quality of life is an important issue in cancer patients. Despite developments of early diagnosis and treatments for cancer, the medical costs is increasing due to extended survival against cancer and the absolute numbers of terminal cancer patients. We assessed the medical costs and quality of life in terminal cancer patients by the types of medical facilities, which would contribute to effective management.
Method: A total 159 patients (males 70, females 89) with terminal cancer patients who were treated and died in various types of medical facilities(home hospice, charity hospital hospice unit, university hospital hospice unit, university hospital non-hospice unit) between November 1, 1997 and January 31, 1999 were included in the study. After the confirmation that the demographic factors correlated with factors of quality of life, the differences in the medical costs and quality of life(pain, depression, ADLs, family APGAR score) during the last 1 week of life in the various types of medical facilities analyzed by multi-way ANOVA with interaction of the significant demographic factors.

Results : The mean cost of types of medical facilities during the last week of patients as 65,332.5 won in charity hospital hospice unit, 105,165.5 won in home hospice, 702,083.4 won in university hospital hospice unit, and 1,037,358.6 won in university hospital non-hospice unit. The difference between free hospital hospice unit and home hospice in medical costs as not statistically significant, but the difference among charity hospital hospice unit and home hospice, university hospital hospice unit, and university hospital non-hospice unit as significant (p<0.001). The demographical factors of quality of life in terms of pain, depression, ADLs, and family APGAR score were compared among various facilities. The ADL score of home hospice was 8.2±3.3, which was lower than free hospital hospice unit and university hospital hospice unit(p<0.05). The mean pain score of home hospice as 1.7±1.7 and that of university hospital hospice as 1.2±1.2, and pain scores of home hospice were lower than free hospital hospice unit, and pain scores of university hospital hospice were lower than free hospital hospice unit and university hospital non-hospice unit(p<0.05). In depressions categorical scale of home hospice the score was 4.8±1.3, which was higher than those of free hospital hospice unit and university hospital non-hispice unit(p<0.05), signifying less depression. The family APGAR score was statistically insignificant among various types of medical facilities.

Conclusion : The cost of hospice care is less than the non-hospice care. We found that the patients of home hospice experienced less pain and depression even with low ADLs, and increased the quality of life in both psychological and physical aspects.
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Medication compliance in the elderly and the factors associated with compliance.
Kyong Chol Kim, Ju Tea Kim, Ji Sun Kim, Hang Suk Cho, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 1999;20(10):1216-1223.   Published online October 1, 1999
Background
: Compliance, defined as the extent to how a person's behavior concedes with medical prescription or advice, has great influence on the treatment. Compliance can be a problem when dealing with chronic medical disorder requiring lifestyle changes and long term treatment. Elderly patients are thought to have more difficulty following prescription because they are generally prescribed more medication, and have more chronic disease. Thus we conducted this study to exam the medication compliance, and the factors associated with compliance in elderly patients.

Methods : The study population consisted of 60 patients (men 31,women 29), older than 60years, who visited a geriatric center geriatric center in a university hospital in September 1, 1998 for one week. We used morisky's self-reported questionnaire which consisted of 4 questions by telephone interview to figure out compliance, and asked 11 questions that may influence compliance, and then collected data - sex, age, number of medication, complexity of prescription, physician number, follow-up days etc. by medical records. We defined compliance as given positing answers to all of the four questions. We analyzed the correlation between compliance and associated factors with x2- test.

Results : Twenty one patients(35%) of the 60 patients were non-compliant. The factors associated with medication compliance were knowledgement of the disease (p=0.020), satisfaction with physician(p=0.012),explanation from physician (p=0
050), number of physician (p=0.024), number of dedication (p=0007), complexity of prescription (p=0.002). But there was no relationship between medication compliance and sea, age, education, perceived seriousness of illness, perceived efficacy of treatment, family support, physical disability, treatment duration, adverse effect, and follow-up days.

Conclusion : Thirty five percent of the subjects were non-compliant. In the factors associated with compliance, the doctor/patient factors as satisfaction with physician, number of physician, number of medication, complexity of prescription have more correlation than patient/disease factor Therefore, we emphasize the role of doctor for improving medical compliance.
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Core procedure of family medicine residency programs.
Ji Sun Kim, Jung Cheon Son, Young Ho Lee, Sun Im Moon, Jee Hye Han, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 1999;20(2):147-157.   Published online February 1, 1999
Background
: There has been no systematic investigation of the necessary core procedures in primary care in Korea. The purpose of this study is to examine the core procedures necessary in primary care and to have the results reflected in residency programs.

Methods : A mail survey was conducted from May 2, to August 20, 1997 among 478 physicians who qualified as a family physician specialist since 1989. The contents of the questionnaire included 1) sex, age, location and size of the hospital 2) of the 93 procedures that should be taught during residency programs as suggested by the [American Academy of Family Physicians] and the [Korean Academy of Family Physicians] a) procedures taught in residency programs, b) procedures performed by practicing family physicians, and, c) procedures considered as necessary in primary care.

Results : 1) Of the 93 procedures, 78 were taught in residency programs, 35 were performed by practicing family physicians, and 77 were considered necessary in primary care. 2) All of the 35 procedures performed by family physicians were taught in the residency programs. Of the 77 procedures considered necessary in primary care, 71 were taught but the remaining 6 were infrequently taught. 3) 7 procedures were taught but were considered unnecessary ; Procedures taught but not actually performed amount-ed to a total of 43. 4) 42 procedures were considered necessary but not performed. 5) More procedures were performed by male doctors(p<0.05). Surgical procedures were performed more often in regional hospitals than those in Seoul and in the larger cities(p<0.05), and more were performed in private practice(p<0.05).

Conclusion : Although almost all of the procedures considered necessary in primary care were taught in residency programs, many procedures were not being performed in current medical practice. We suggest that it would be more effective to intensively train the core procedures than to provide exposure to a wide array of procedures. As the procedures performed were found to vary in relation to sex, location and size of the attending hospital, it would be desirable for training programs to accommodate individual needs, giving residents access to specific procedures needed for their future.
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Development of an OPD-based childhood obesity control program and the effects of its utilization.
Hye Ree Lee, Yun Ju Kang, Jae Yong Shim
J Korean Acad Fam Med 1998;19(10):787-800.   Published online October 1, 1998
Background
: Although childhood obesity is an increasing public health problem in our society and a number of regimens have been developed and distributed for the treatment of adult obesity, few studies have focused on therapeutic programs for obese children. The objective of this study was to develop and measure the effects of an OPD-based childhood obesity control program.

Methods : The OPD-based childhood obesity control program was developed by reviewing the preexisting literature and consulting specialists. It was applied to the 4-6th grade obese(obesity index≥30%) children. The effects of intervention were assessed by the changes in obesity-related behavior, caloric and nutrient intake and exercise amount. The effects in the OPD-based group(group I) were also compared with the school-based group(group II)and the no intervention group(group III).

Results : The OPD-based program was developed based on behavioral modification principles such as self monitoring, stimulus control, positive reinforcement, social support, cognitive change and behavioral contracts and contained diet and exercise therapy. The developed program was applied to 34 pairs(child and mother) in the treatment group of which 21 pairs completed the basic sessions and 17 pairs completed the additional follow up session. Significant changes, decreases in obesity index were observed in the OPD-based group. No significant changes were found in the school-based group whereas increased degrees of obesity were found in the no intervention group. Obesity related behavior scores were significantly increased in both the OPD- and school-based groups. The children in both the OPD-based group showed significant decrease in dietary intake and increase in exercise amount.

Conclusion : Although it was a short-term treatment result, the OPD-based program was more effective than the school-based program in childhood obesity control. We suggest that a control program of comparable intensity and individualization as ours is required, for effective childhood obesity control.
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Psychosocial Aspects of Obse Adolescents.
Jae Yong Shim, Yun Ju Kang, Hye Ree Lee, Hee Choul Ohrr
J Korean Acad Fam Med 1998;19(4):337-352.   Published online April 1, 1998
Background
: The prevalence of adolescent obesity is so rapidly increasing in Korea that there are concerns not only for increased risk of adult obesity in the future, but also for psychosocial problems in this period. This study is to find out the psychosocial correlates of adolescent obesity such as demographic characteristics, concerns about body image and weight, self-esteem, depression, and the locus of control for obesity.

Methods : A total of 963(obesity, 433 ; normal weight, 530) among 8,209 students from schools that underwent survey of physical examination in Seoul were assessed with a self-administered questionnaire.

Results : There were statistically significant differences between the obese group(OG) and the normal weight group(NWG) in family structure(p<0.05) and economic status(p<0.01). Adolescents in a extended family were more frequent in the OG(14.3%), than in th NWG(9.4%). Those in the high economic status were less frequent in the OG(15.3%) than in the NWG(23.8%). Although almost all obese adolescents considered that they were fat, normal weight students did not view themselves as they really were(p<0.001). That is, 57.5% of the NWG thought that they were either fat of thin instead. The majority of the OG was not satisfied with(86.4%) and worried(88.0%) about their weight(p<0.001), and these aspects were more remarkable in women(p<0.001). The total self-seteem score in the OG was higher(p<0.001) than the NWG, and the depression score was lower in the OG than the NWG(p<0.001). Higher scores for powerful others and chance in th OG than those in NWG were shown(p<0.001). The psychosocial aspects which were highly associated with obesity were self-esteem in peers(odds ratio=1.547) and school(odds ratio=2.041), and powerful others(odds ratio=2.181) and chance(odds ratio=2.367) locus of control for obesity, and less probable characterisrics were depression(odds ratio=0.723) and high economic status(odds ratio=0.498).

Conclusion : Obese adolescents neither had low self-esteem nor were they depressive to the contrary of belief in the general public. Since they were not satisfied with and worried about their body weight, however, there is a need to change our misconception of obese people who may risk unhealthy weight reduction. Further studies using various insrtuments and reinforcing internality for management of obesity would be needed to deeply understand the psychosocial correlates of obesity.
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A Study on the Fallow up of the Adolescents with Tuberculosis on Mass Miniature Radiography in Seoul.
Bom Taeck Kim, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 1998;19(2):118-124.   Published online February 1, 1998
Background
: Despite the declining tendency of the prevalence of tuberculosis in Korea, pulmonary tuberculosis is still considered to be such an important disease in Korea that tuberculosis of patients have been screened by mass miniature radiography(MMR). Although the prevalence of tuberculosis increases with age, screening of it has been done on students and young workers. There hasn't been any study about the prevalence of tuberculosis in adolescents recently.

Methods : MMR were performed on high school freshmen in Seoul from March to September, 1995. Patients with abnormal MMR were further evaluated on history taking and standard chest X-ray, Their results were classified as normal, active tuberculosis, activity-undetermined tuberculosis, healed tuberculosis, and other diseases. The prevalence of active tuberculosis by this screening method was estimated.

Results : Among 194,102 high school freshmen, 388 were suspected to have pulmonary tuberculosis by MMR. The prevalence of tuberculosis in high school freshmen in Seoul was 0.20%, male 0.18%, female 0.23% by MMR respectively, There was significant difference between the prevalences of both sexes. History taking and standard X-ray was taken for 94 students and among them 68 students were found to have active tuberculosis(72.3%), 14 normal(14.9%), 3 other diseases(3.2%), 9 healed or activity-undetermined tuberculosis(9.6%). Newly-diagnosed patients in active tuberculosis were 59(82.9%). There were family history in 31 out of 94 students(33.0%) and 29 out of 68 students(37.1%) with active pulmonary tuberculosis had family history of tuberculosis.

Conclusion : The prevalence of pulmonary tuberculosis in high school freshmen in Seoul was 0.20% by MMR. Positive predictive value of MMR was 72.3% in follow-up students by standard chest X-ray. Therefore estimated prevalence of active pulmonary tuberculosis by standard chest X-ray after MMR was 0.14%.
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The Effect of Family Registration Program.
Hye Ree Lee, Eui Shik Chung, Yoo Sun Moon, Duk Chul Lee, Jae Yong Shim
J Korean Acad Fam Med 1996;17(9):761-774.   Published online September 1, 1996
Background
: The national health care system where primay care health service functions properly, provide better medical outcomes in individual health service as well as national health policy. This is quasi experimentally designed, prospective study for the purpose of developing a model of primary health service in Korea. We provided Family Registration Program reinforcing primary health care for 1 year in order to assess medical outcomes and verify the benefit of the program.

Methods : Three board certified family physician assigned to 263 families, 1057 people provide 6 items of medical service reinforcing accesibility, comprehensiveness, continuity, accountability for 1 year. After the program the use of the medical services was reviewed by the medical records, to assess the quality of care during the program two self reporting questionnaire surveys was perfor-med by Continuity, Comprehensiveness, Personal relationship Questionnaire(CCPQ) before and after the program. Another self reporting questionnaire survey was also performed to assess the factors relating the use of the program.

Results : Over the seventy percents of families utilized at least one service item, most frequently using service item was medical service in outpatient department, total number of visit was 695 by 161 people in 102 families. The number of beeper call was 226, 75.3 per a family physician. The reason of beeper call were medical problem(59.7%), services to inform laboratory result(25.9%), and appointment for medical service(13.7%). The scores of CCPQ before and after program were 6.48±1.48 and 8.66±1.76, which meant that better quality of medical service was provided during the program. The reason for under-utilization of the program were 'No health program'(52.9%), 'Not Familiar with how to use the program' (34.3%), 'Felt sorry to call'(20.6%), which meant many families misunderstood the program. Over the seventy percents families had visited other physicians' offices during the program by the reasons of 'Near home' (56.7%), 'Already have a regular doctor'(26.9%). Sixty eight percents families satisied the program and 88.1% of families willed to participate in the re-registraion program.

Conclusion : By the fact that most of families registered were satisfied with familiy registration program, we conclude that this program provided quality care and could be settled in our medical system, but still remains a lot of efforts to make to have such a program known to public and utilized by many people.
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Life Change Events of Adolescent Patients in Primary Care.
Young Sik Kim, Jae Yong Shim, Shin Whi Lee
J Korean Acad Fam Med 1996;17(8):674-685.   Published online August 1, 1996
Background
: This study was performed practicing primary care and was intended to find out their common disease types, contents of life change events, amount of stress and family functions among adolescent patients visiting outpatient departments of family medicine. It can develop an app-roach to adolescent patients and provide basic data to evaluate associations between disease and stress.

Methods : Self-administered questionnaire consisting of reasons for visits, 45 life change events and 20 family functions was completed by adolescents aged 13 to 19 who visited 2 outpatient departme-nts of family medicine from Dec. 1993 to Aug. 1994 while they were waiting to see their family docotrs.

Results : Of the total 184 subjects, males were 111 and females were 73. The most common reason for visit was physical complaint and the most common symtom was headache. The most common diagnosis was functional gastrointestinal disease. The most frequent life change event was 'easy distraction due to day dreaming and spurious thoughts.' 'School problems and anxiety about carrier planning' was the most frequent category among 8 categorized life change events. 'Death of sibling' and 'acquiring visible deformity' received the highest scores in life change units. The most common family function type was categorized as rigid in adaptability and disengaged in cohesion. Balanced families were 13.3%, - mid-range 50.0%, and extreme 36.7%, respectively. There were no differences between groups with or without some diagnosis of physician in numbers of life change events, amount of stress and family functions.

Conclusion : Most of the adolescent patients' diseases in this study were problems that could be managed in priamry care, and many of them required biopsycosocial approaches. The assessment of life change events, amount of stress and family functions of adloescent patients in the outpatient department is considered to be helpful to understand adolescent patients.
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The Usefulness of Acupoints in the Diagnosis of Acute Appendicitis.
Geun Ho Cho, Song Hee Yoo, Bom Taeck Kim, Jae Yong Shim, Duck Chul Lee, Hye Ree Lee
J Korean Acad Fam Med 1996;17(2):133-142.   Published online February 1, 1996
Background
: Acute appendicitis is one of the common surgical diseases which urgent diagnosis is needed in emergency or primary practice. But its diagnosis can be complicated because acute appendicitis has diverse clinical manifestations. Moreover facilities for accurate diagnosis are limited in most primary practice, so we investigated the usefulness of acupoints in the diagnosis of acute appendicitis as the more accurate, easy and simple method.

Methods : The number of appendicitis patients group were 26, whose diagnosis was confirmed by pathology after operation (appendicitis patients group). For the control groups, we selected 20 patients of acute abdominal pain whose clinical diagnosis were other than acute appendicitis (nonappendicitis patients group). Another 20 persons were selected for healthy control group. The subjects of each group were measured the pressure pain threshold by pressure algometer at four acupoints of right lower leg. The four acupoints were Joksamni, Nanmi, Sangeoher, Jogu. We analysed the mean pressure of pain threshold and the order of pain intensity at each acupoint and group.

Results : There was no statistical difference of age and sex in each group. The mean pressure of pain threshold at the Nanmi acupoint ; in appendicitis patients 2.98±0.93㎏/㎠, in nonappendicitis patients 3.79±1.04㎏/㎠, in healthy control 5.08±1.05㎏/㎠, The appendicitis patients' pressure of pain threshold was lower than other groups(p<0.001). The mean pressure of pain threshold in appendicitis patients at each acupoint were as following : nanmi acupoint 2.98±0.93㎏/㎠, Joksamni 4.08±1.61㎏/㎠, Sangeoher 4.75±1.43㎏/㎠, Jogu 5.58±1.47㎏/㎠. The Nanmi acupoint was lower than other acupoints(p<0.001). The diagnostic values of the Nanmi acupoint by the pressure of pain threshold were as following: if the pressure was lower than 3.0㎏/㎠, the sensitivity of diagnosis was 76.9%, specificity was 82.5%, if the pressure was lower than 3.5㎏/㎠, the sensitivity and specificity was 88.5%, 75.0% respectively. The diagnostic value by the order of pain inthnsity; in the most painful acupoint was the Nanmi, the sensitivity was 92.2% and the specificity was 70.0%. The diagnostic alue by the combination of pressure and order of pain intensity : if the most painful acupoint was the Nanmi and the pressure threshold was lower the 3.5㎏/㎠ at the Nanmai, the sensitivity and specificity were 80.1%, 80.0% respectively.

Conclusion : If the pressure threshold was lower than 3.5㎏/㎠ at the Nanmi acupoint and the most painful acupoint was the Nanmi acupoint, acute appendicitis could be diagnosed in sensitivity 80.1% and specificity 80.0%.
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(Physician's thinking and behavior on patient education in practice)
Hye Soon Park, Shin Hwi Lee, Jae Yong Shim, Jeong Jin Cho, Ho Cheol Shin
J Korean Acad Fam Med 1995;16(11):362-362.   Published online November 1, 1995
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Background
: Improving quality of care by increasing continuity, comprehensiveness, and personal relationship of care is one of the important concepts in family medicine. A self-report questionnaire was designed to assess the improvement in quality of care from the above 3 aspects of care

Methods : 27 questions about the 3 concepts were designed by 5 family physicians and were given to 8 other family physicians and 13 residents to evaluate whether each question meant what it was originally intended to mean. or not. It there was a consistency more than 50% between the testees and the developers, those questions were considered to have content validity and were pilot-tested to decide whether they had internal consistency among questions of the same concept or not. Finally were given the chosen questions to patients visiting family medicin clinics of 3 university hospitals. Comparison was made between the new patient group and the old patient group to evaluate whether there were any differences as expected or not.

Results : 24 questions were considered to have content validity among the original 27 questions. Finally were chosen 21 questions with internal consistency consisting of 4 continuity items (a=0.795), 9 comprehensiveness items (a=0.700) and 9 personal relationship items (a=0.616). The scores of total, continuity, comprehensiveness and personal relationship in the old patient group were significantly higher statistically (P<0.01) than those of the new patient group.

Conclusion : our questionnaire could be used to assess the quality of care indirectly in family practice which has a goal of increasing continuity, comprehensiveness and personal relationship in care.
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Original Article

The predictive factors influencing on the juvenile delinquency.
Hye Ree Lee, Yoo Sun Moon, Jae Yong Shim, Dong Su Lee, Chul In Kim
J Korean Acad Fam Med 1995;16(10):731-738.   Published online October 1, 1995
Background
: Increasing juvenile delinquency has developed as a social problem and adolescent in tis characteristics has tendency not to exposure their problems to physician. For early detection and anticipatory guidance of juvenile delinquency by finding predictive factors of delinquency, we are intended to investigate into the correlation between juvenile delinquency and predictive factors of juvenile delinquency.

Methods : A self-reported questionnaire survey was conducted on 1,266 high school students in Kangnam-Ku, Seoul, from March to May 1994. We made statistical analysis of the family APGAR score, demographic data and delinquency score by means of correlation and multiple regression.
Demographic factors include age, sex, family income, deucational status of parents, and pocket money indicating family background and examination rank indicating their achievement in school.

Results : The factors significantly associated with juvenile delinquency score were pocket money (r=0.508), age(r=0.428), family APGAR score(r=0.367), and examination rank(r=0.281) and R² was 0.44 Compared with female students, male students were significantly high in delinquency score.

Conclusion : Tendency of juvenile delinquency was significantly high in male students, and was related with age, much pocket money, low family APGAR score, low exmination rank in this study.
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