Korean Journal of Family Medicine

Discussion on the Clinical Course of Adverse Effects after COVID-19 Vaccination: A Retrospective Analysis of Case Series in an Outpatient Department: Jae Hyung Rhim, Hyun Hwa Shin, Chulmin Kim, Whan Seok Choi, Kyung Soo Kim, Chang Jin Choi; Korean J Fam Med 2023;44(1):28-34. Published online January 19, 2023; DOI: https://doi.org/10.4082/kjfm.21.0212

Abstract
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Background
A total of 8,303 individuals (4.3%) with adverse reactions (n=191,860) after vaccination developed serious conditions or died. Such health developments could cause people not vaccinated yet or waiting for a booster shot to become fearful of the vaccination.
Methods
The 3-month (July–September 2021) clinical data of 41 patients from the family medicine department of a single medical center were analyzed retrospectively to determine risk factors and to investigate the clinical course to identify the cause of symptoms in detail.
Results
A significant number of older adults aged over 50 years reported experiencing general weakness (P=0.026) but fewer incidences of fever than patients aged 50 years or younger (P=0.011). Eighteen of the 41 patients were requested to visit more than twice or consult a specialist. In 14 patients, the symptoms were explained by other medical causes.
Conclusion
The primary physician has a pivotal role in thoroughly evaluating patients who complain of adverse effects after vaccination, considering the broad multitude of symptoms and medical conditions presented. To thoroughly evaluate and appropriately advise patients with adverse reactions to their chosen vaccine, taking detailed medical history and nutritional counseling are required to identify possible underlying causes, resolve symptoms, and educate them on self-care and regarding vaccines.

Citations

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Risk of anxiety disorders and insomnia following COVID-19 vaccination
Haerin Cho, Joon Hyung Jung, Hwoyeon Seo, Won Chul Shin, Jung-Ick Byun, Suvin Park, Na-Young Jeong, Sanghoon Oh, Nam-Kyong Choi
Journal of Psychiatric Research.2026; 192: 109. CrossRef
Correspondence: Clinical Course of Adverse Effects after COVID-19 Vaccination
Amnuay Kleebayoon, Viroj Wiwanitkit
Korean Journal of Family Medicine.2023; 44(5): 299. CrossRef

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Olfactory Function Test for Early Diagnosis of Vascular Dementia: Kang Duk Suh, Sun Mi Kim, Doug Hyun Han, Hyun Jin Min, Kyung Soo Kim; Korean J Fam Med 2020;41(3):202-204. Published online May 20, 2020; DOI: https://doi.org/10.4082/kjfm.18.0202

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Olfactory impairment occurs in patients with Alzheimer’s disease, and olfactory function tests are performed for the diagnosis of Alzheimer’s disease. However, the diagnosis and patient status are not currently outlined for vascular dementia, and many physicians do not consider concurrent vascular dementia in patients complaining of olfactory dysfunction. Here, we report a case of vascular dementia with no symptoms of dementia other than olfactory dysfunction. This case suggested that the olfactory function test is helpful not only for the diagnosis of Alzheimer’s disease but also for the early diagnosis of vascular dementia.

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Odor-Based Molecular Communications: State-of-the-Art, Vision, Challenges, and Frontier Directions
Dilara Aktas, Beyza E. Ortlek, Meltem Civas, Elham Baradari, Ahmet B. Kilic, Fatih E. Bilgen, Ayse S. Okcu, Melanie Whitfield, Oktay Cetinkaya, Ozgur B. Akan
IEEE Communications Surveys & Tutorials.2025; 27(4): 2658. CrossRef
Odor Intensity Shift Keying (OISK) and Channel Capacity of Odor-Based Molecular Communications in Internet of Everything
Aditya Powari, Ozgur B. Akan
IEEE Transactions on Molecular, Biological, and Multi-Scale Communications.2024; 10(3): 396. CrossRef
Inflammation and olfactory loss are associated with at least 139 medical conditions
Michael Leon, Emily T. Troscianko, Cynthia C. Woo
Frontiers in Molecular Neuroscience.2024;[Epub] CrossRef
Olfactory loss is a predisposing factor for depression, while olfactory enrichment is an effective treatment for depression
Michael Leon, Cynthia C. Woo
Frontiers in Neuroscience.2022;[Epub] CrossRef

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Referred Otalgia Induced by a Large Tonsillolith: Kyung Soo Kim; Korean J Fam Med 2013;34(3):221-223. Published online May 24, 2013; DOI: https://doi.org/10.4082/kjfm.2013.34.3.221

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Herein, we report an unusual case of large tonsillolith presented with acute otalgia. Since the tonsils and tonsillar fossa are supplied by the glossopharyngeal nerve, any irritation or pain can be referred to the ear along the tympanic branch of the glossopharyngeal (Jacobson's) nerve. Also, it is worth re-emphasizing that normal otoscopy must be followed by inspection of the nasal cavities, oral cavity, and oropharynx, with particular note given to the floor of mouth, teeth, tongue, and tonsils because the identification of a causative etiology is necessary to successfully treat referred otalgia.

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Citations to this article as recorded by

Ipsilateral Referred Otalgia: “Think Carefully” Before You Miss the Patient!
Yasser Al-Ghabra
Ear, Nose & Throat Journal.2026;[Epub] CrossRef
Development of tonsil stones during pregnancy
Drew H Smith, Joann Gold, Yusuf Dundar, Joehassin Cordero, Christine D'Aguillo
Obstetric Medicine.2025; 18(1): 40. CrossRef
Glossopharyngeal Neuralgia and Somatic Tinnitus Caused by a Small Tonsillolith
Han Kyu Cho, Jayoung Oh, Ja-Won Koo
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2022; 65(1): 62. CrossRef
Secondary Otalgia: Referred Pain Pathways and Pathologies
C.D. Norris, N.A. Koontz
American Journal of Neuroradiology.2020; 41(12): 2188. CrossRef
Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths
Melih Ozdede, Gulsun Akay, Ozge Karadag, Ilkay Peker
Medical Principles and Practice.2020; 29(3): 279. CrossRef

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The Changes in Heart Rate Variability between Morning and Afternoon.: Chang Jin Choi, Whan Seok Choi, Kyung Soo Kim; J Korean Acad Fam Med 2008;29(8):579-584. Published online August 10, 2008

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Background
Short-term measurement of heart rate variability is known to be a non-invasive technique to examine autonomic nerve system. Heart rate variability exhibits circadian rhythm according to work/sleep cycle and biological clock. In primary practice, short-term measurement of heart rate variability is usually used during the day. Therefore the aims of this study were to investigate the possibility of differences in heart rate variability between morning and afternoon and also to examine the relationship among associated factors. Methods: Sixty-eight healthy volunteers underwent short- term measurement of heart rate variability on two occasions: in the morning (08：30∼11：00) and in the afternoon (13：30∼16：00). A structured questionnaire was used to access general characteristics, emotion, fatigue and sleeping hours. Results: The mean heart rate was significantly increased and SDNN, RMSSD, TP, HF and VLF were significantly decreased in the afternoon compared to the morning. LF and LF/HF were not changed. The anxiety group, the depression group and the fatigue group showed significantly greater reduction in TP and RMDDS than the control group. Conclusion: In the afternoon, parasympathetic activity and total power were decreased significantly compared to the morning. Short-term heart rate variability should be measured in the same time zone and need to consider food intake effect. Those who complained of anxiety, depression or fatigue were related to much decrease in TP and RMSSD in the afternoon. (J Korean Acad Fam Med 2008;29:579-584)

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The Cognitive Subscale of Alzheimer's Disease Assessment Scale (ADAS-Cog) for Patients with Alzheimer's Disease in Korea.: Se Hong Kim, Hyun Kook Lim, Kyung Soo Kim, Ju Hye Chung; J Korean Acad Fam Med 2007;28(11):853-859. Published online November 10, 2007

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A Case of Idiopathic Intracranial Hypertension Associated with Obesity.: Se Hong Kim, A Reum Han, Kyung Soo Kim; J Korean Acad Fam Med 2007;28(8):626-630. Published online August 10, 2007

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Idiopathic intracranial hypertension, or Pseudotumor cerebri is a disorder characterized by symptoms and signs of a space-occupying intracranial mass without any evidence of mass or ventricular obstruction. We experienced a 28 years old obese woman who was presented with headache and progressive visual disturbance for one month. She presented bilateral papilledema with visual field defect. On MRI investigation no intracranial abnomality were observed. Lumbar puncture showed increased intracranial pressure and normal biochemical and cellular findings. The patient was diagnosed idiopathic intracranial hypertension and treated with therapeutic lumbar puncture, acetazolamide, furosemide, weight control and symptoms resolved gradually. We conclude that weight reduction is difficult to accomplish but always needed in idiopathic intracranial hypertension. (J Korean Acad Fam Med 2007;28:626-630)

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BMI-related Changes in Bone Mineral Density and Predictors of Bone Loss.: Il Woo Joo, Yeol Soo Park, Kyung Soo Kim, Han Jin Oh; J Korean Acad Fam Med 2006;27(6):481-487. Published online June 10, 2006

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Background
: Osteoporosis and hyperlipidemia in postmenopausal women may develop due to a sudden decrease of estrogen. In general, women over 60, about 10 years after menopause, are at risk of continuous bone loss. However, many reports reveal that high body weight may have a preventive effect on bone loss. There are few studies that examine the effect of body mass index on bone loss in aged Korean women. The aim of this study was to show the effect of body mass index on bone loss in aged Korean women.

Methods : We evaluated 510 women aged over 60 who visited a health care center of a university hospital in Seoul from January 1999 to December 2004 to determine the effects of body mass index on bone mineral density in aged Korean women. We measured anthropometrical characteristics, BMD of lumbar spine, markers of bone turnover, and FSH of the subjects.

Results : The higher body mass index, the greater BMD at lumbar spine. But the levels of alkaline phosphatase, osteocalcin and deoxypyridinoline had no significant differences. The FSH level was also low in the high body mass index group. The BMI was positively correlated with BMD (P＜0.01) by Pearson's correlation matrix. The total alkaline phosphatase also had a significant negative correlation with BMD. The levels of FSH had negative correlation (P＜0.01) with BMD.

Conclusion : Higher body mass index groups showed higher BMD with lower FSH levels. Further prospective studies considering the endocrinologic association with body weight, BMD and FSH level will be needed.

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Age Associated Changes in Body Mass Index and Body Fat Distribution.: Jung Ho Lee, Chan Hee Song, Keun Sang Yum, Kyung Soo Kim, Soon Woo Nam, Jun Yeol Han, Gyu Won Jeong, Hei Sik Sun; J Korean Acad Fam Med 2003;24(11):1010-1016. Published online November 10, 2003

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Background
: Body mass index is currently applied as the diagnostic standard of overweight and obesity, regardless of age. Percentage body fat ratio applies separate standards among different sex, but does not have separate standards for different age groups. Since body mass index and percentage body fat may differ according to age, we conducted this study to see if a separate standard for overweight and obesity is indeed necessary for different age groups.

Methods : We selected 2,190 subjects, who were the 10 percent picked randomly by computer, among 21,921 clients who had visited the St. Mary's Hospital's health promotion center in Seoul. Those diagnosed with diabetes, thyroid disease, renal failure, and tuberculosis were excluded, leaving 1,939 over the age of 20, as final subjects. Anthropometric measurements were done using electronic scales and height meters, while body composition was measured with a multi-frequency bioelectric impedance analysis (Inbody 3.0 Biospace, Seoul). The results of this study were shown in mean and standard deviation, and mean values according to ages were compared by Ancova test.

Results : In the case of adult men, percentage body fat increased with age. This was observed especially with subjects over 30 compared to subjects in their 20s, although not proven to be statistically significant. A decrease in fat free mass rather than increase in body fat mass was noted with aging. With adult women, percentage body fat increased markedly with subjects over 50, mainly due to increased body fat mass rather than decreased fat free mass. Subjects exceeding a body mass index of 25, which is the standard limit of body mass index for obesity, was 60th percentile for adult men, and 70∼80th percentile for adult women. Percentage body fat in this case was 22.54% for men and 31.99∼33.46% for women.

Conclusion : Our study indicates that both men and women show changes in body mass index and fat free mass with aging. Hence, there are limitations to applying a universal standard for body mass Index, regardless of age. We suggest that further studies on standards for adult obesity should be conducted based on specific Korean epidemiologic data.

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Past, Present and Future of The Korean Academy of Family Medicine (KAFM).: Kyung Soo Kim; J Korean Acad Fam Med 2003;24(8):696-701. Published online August 10, 2003

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The Association between Obesity Indices and Physical Fitness.: Yun Joo Jung, Jin Hee Shin, Keun Sang Yum, Chan Hee Song, Whan Seok Choi, Kyung Soo Kim, Jin Hee Park; J Korean Acad Fam Med 2003;24(3):271-278. Published online March 10, 2003

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Background
: Physical fitness is defined as the ability to carry out work necessary for muscle exercise satisfactorily. Generally, obese person have been considered to have low physical performance. In addition, obesity has been known to be a risk factor of cardiovascular disease such as hyperlipidemia, hypertension, and coronary arterial disease. Based on previous epidemiologic studies, abdominal obesity, especially, visceral obesity, is thought to be more important risk factor for cardiovascular disease rather than obesity itself. Therefore, the interest on assessment of abdominal visceral fat has been increasing. The aim of this study was to see the difference in physical fitness and blood pressure according to obesity degree assessed by BMI, and compare the anthropometric obesity indices with abdominal visceral fat accumulation measured by abdominal CT (Computed Tomogram).

Methods : Four hundred thirty-two subjects, who participated in the exercise program for more than one month duration at the 'Clinic for Obesity' in St. Mary's Hospital from November 1998 to June 2000, were included in the analysis. They were categorized into 4 groups [severe obesity group (BMI≥30), obesity group (25≤BMI＜30), overweight group (23≤BMI＜25), normal group (BMI＜23)] according to their BMI. Blood pressure, anthropometric obesity indices and physical fitness (V0₂ max, back muscle strength, sit up, forward bending, vertical jump, side step, balance) were measured by one skillful exercise trainer. Among them, one hundred thirty-one subjects performed abdominal CT to assess visceral fatness. We compared anthropometric indices (waist to hip ratio, body mass index, abdominal circumference, skin foldness) with abdominal visceral fat accumulation measured by CT.

Results : Blood pressure, cardiovascular endurance, muscular endurance, muscle strength, speed and balance were significantly different among the four groups categorized by BMI in both sexes, but flexibility and agility were not significant. In women, the correlation coefficients between visceral fat area measured by abdominal CT and each of waist to hip ratio, BMI, abdominal circumference, and skin foldness adjusted for age were 0.487, 0.479, 0.464, 0.31, respectively (P＜0.01). However in men, there were no significant correlations.

Conclusion : Obesity tended to increase blood pressure, and reduce physical performance. Only in women, obesity related indices reflected the abdominal visceral fat accumulation.

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Counseling about Teratogenicity Risks Associated with Medications during Pregnancy.: Kyung Soo Kim; J Korean Acad Fam Med 2003;24(1):11-18. Published online January 10, 2003

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Effects of Dietary Antioxidant Vitamins and Fiber on the Risk of Myocardial Infarction.: Ju Hye Chung, Chang Jin Choi, Kang Sook Lee, Chin Eun Chung, Kyung Soo Kim, Hyo Seok Ahn; J Korean Acad Fam Med 2002;23(12):1423-1431. Published online December 10, 2002

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The Effects of L-theanine Containing Functional Beverage on Mental Relaxation and Fatigue Perception.: Chan Hee Song, Kyoo In Chung, Sang Wook Song, Kyung Soo Kim; J Korean Acad Fam Med 2002;23(5):637-645. Published online May 31, 2002

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Background
: L-theanine is one of the most popular amino acids in green tea and has been known to produce mental relaxation, lower blood pressure and improve learning ability in human beings. But, few studies on these effects for human beings have been conducted so far. This study was conducted to evaluate the effect of L-theanine containing functional beverage on mental relaxation and fatigue perception.

Methods : Twenty healthy volunteers aged 30 to 55 years those who has had persistent fatigue for more than 1 month without any specific disease were recruited through written advertisement. All the subjects gave their informed consent, and the study was approved by Institutional Review Board of St. Mary's Hospital. This study was performed in a randomized placebo controlled double blind cross over fashion. Pathologic fatigue due to disease state was screened through medical history, physical examination, laboratory tests and questionnaires. a to B power value of EEG as a surrogate marker of mental relaxation was measured in frontal and occipital regions for an hour after administration of placebo or test (200 mg L-theanine)solutions and crossed over at 7-day intervals. We analyzed a to B power value of EEG in frontal and occipital regions at 10 minute intervals for each 5 minutes. The baseline and 7-day follow-up scores of fatigue severity scale (FSS) were also evaluated.

Results : Repeated ANOVA revealed that there were significant differences of frontal a to B power value between placebo and test in high anxiety group (P<0.01). The mean values at 15, 25, 35, 45, and 55 minute intervals were 0.57, 0.48, 0.52, 0.66, and 0.61 in placebo, respectively, and 0.73, 0.82, 0.78, 0.91, and 0.97 in test, respectively. But there were no significant differences of frontal a to B power value between placebo and test groups with low anxiety (P>0.05). Fatigue score was significantly decreased in test (P<0.05), but not in placebo (P<0.05) after 7-day administration of placebo or test solutions. The mean differences from baseline in placebo and test were -0.42, and -0.80, respectively.

Conclusion : The results of this study suggest that L-theanine containing functional beverage should promote a to B power value in relation to mental relaxation, and also have the effect of reducing the fatigue perception.

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Clinical Trial Design and Ethics.: Kyung Soo Kim; J Korean Acad Fam Med 2002;23(5):573-582. Published online May 31, 2002

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The relationship between physical fitness and fatigue among female employees in general hospitals.: Chan Hee Song, Jin Hee Shin, Kyoo In Chung, Keun Sang Yeum, Kyung Soo Kim; J Korean Acad Fam Med 2002;23(3):353-364. Published online March 1, 2002

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Background
: Physiological fatigue due to excessive physical activities and lack of proper rest is commonly observed among workers. Previous studies suggested that physiological fatigue can be related to individual physical fitness. This study was conducted to investigate the relationship between physical fitness and the degree of fatigue in 95 female employees in general hospitals.

Methods : Subjects were healthy adults female volunteers who were employed by two general hospitals located in Seoul and Kyunggido. The degree of fatigue using fatigue severity scale and physical fitness including % body fat, waist-hip ratio, maximal oxygen uptake, both grip strengths, back muscle strength, sit ups, flexibility, and broad jump were assessed. Data were strengths, back muscle strength, sit ups, flexibility, and broad jump were assessed. Data were analysed to examine the relationship between the degree of fatigue and each physical fitness.

Results : 1. Fatigue severity scale was significantly increased with increasing age and commuting time. Drinking alcohol was significantly related to increased fatigue severity scale.
2. Fatigue severity scale was significantly decreased with increasing number of family members and length of service.
3. Fatigue severity scale was significantly decreased with increasing both grip strengths, maximal O₂uptake, and sit ups.

Conclusion : The physical fitness factors including both grip strengths, maximal O₂uptake, and sit ups were considered to be important predictors in the evaluation of the degree of physiological fatigue.

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The diagnosis distribution in health examination and associated sociodemographic factors.: In Ho Kim, Kang Eun Lim, Kyung Soo Kim, Min Soo Park, Seung Wook Hwang, Tai Woo Yoo; J Korean Acad Fam Med 2001;22(7):1067-1076. Published online July 1, 2001

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Background
: According as people have an increased interest in early detection of disease and health promotion, people who take health examinations are increased. So this study is aimed to survey common problems about health in community and their frequency by way of investigation on diagnosis in health examination data and to evaluate the effects of risk factors on each disease patterns.

Methods : The medical records of the clients who have taken health examinations for the first time from March 1995 to February 2000 at a health examination center of a university hospital in Seoul were reviewed. The category and number of judged diagnosis, sociodemographic factors are compared and analyzed.

Results : The selected medical records accounted to 22,393. The study subjects consist of 11,544(51.6%) male. Mean age is 52.0±105 years(range 16~90). Mean number of judged diagnosis is 4.04±2.13(range 0~9) per one person and female took more diagnosis than male on an average(4.09±2.17 Vs 3.99±20.9). The organic diagnosis(56.4%) is most in total and other diagnosis is 35.7%, functional diagnosis is 7.9%. The common diagnoses are liver disease(7.17%), decreased physical strength(6.68), hyperlipidemia(6.53%), obesity(5.90%), osteoporosis or postmenopausal syndrome(4.72%), need for immunization against viral hepatitis(4.69%), hypertension(4.20%), functional gastrointestinal disease(3.93%). The number of total diagnosis and organic diagnosis is larger in older age, no exercise, female, smoker, no-spouse, lower education(p<0.05). The number of functional diagnosis is larger in female, younger age, non-smoker, lower education(p<0.05). The number of other diagnosis is larger in no exercise, smoker, female, younger age(p<0.05).

Conclusion : According to health examination, total diagnosis and organic diagnosis are influenced by age, exercise, sex, smoking, spouse, education, functional diagnosis is influenced by sex, age, smoking, education and other diagnosis is influenced by exercise, smoking, sex, age.

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A prospective study on the antihypertensive monotherapy in family practice.: Young Sik Kim, Byung Sung Kim, Kyung Soo Kim, Hoon Ki Park, Yoo Seock Cheong, Esther Yeo, Tae Hee Jun, Seung Pil Jung, Ji Ho Choi, Sang Yeoup Lee, Yun Jin Kim, Young Kyu Park; J Korean Acad Fam Med 2001;22(6):828-839. Published online June 1, 2001

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Background
: There are very few cohort studies on the hypertension in family practice. In order to investigate epidemiological characteristics of hypertensive patients and assess the safety and tolerabiliy of newly prescribed antihypertensive monotherapies in Korean patients, a prospective study was carried out.

Methods : A total of 1,181 patients were observed from July 1997 to August 1999. At 2,4,8 and 12 weeks after initiation of antihypertensive monotherapy, the patients were evaluated for whether treatment is continued and development of any adverse reactions.

Results : Calcium channel blockers(CCBs) were the most commonly prescribed initial drug class(44.2%) in family practice, followed by angiotensin converting enzyme inhibitors(ACEI) (21.0%), angiotensin II receptor antagonists(ARA) (11.8%), B-blockers(9.6%), a-blockers(3.9%), and diuretics(3.6%), During the first 12 weeks, the percentage of subjects continuing their initial ACEIs(40.7%) was substantially lower than the percentages that of subjects continuing ARAs(66.2%), a- blockers*(63.0%), CCBs(61.3%), B-blockers(55.8%), and diuretics(53.5%), respectively(P<0.001), The following adverse reactions were detected: cough(7.5%), headache(6.1%), dizziness(3.9%), flushing(3.7%), and impotence(2.4%). The incidence of cough associated with ACEI(27.9%), was higher than those of other classes(P<0.01)

Conclusion : CCBs were the most commonly prescribed initial drug class in family practice, followed by ACEIs, ARAs, B-blockers, a-blockers, and diuretics. The tolerability of antihypertensive medication was the highest in Korean patients treated with ARAs, followed by CCBs, B-blockers, diuretic, a-blocker, and ACEIs.

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Validity analysis of for exercise tests in assessing aerobic capacity of young men.: Chang Jin Choi, Kyung Soo Kim, Sun Myeong Ock, Chan Hee Song, Keun Sang Yeum, Yeun Sook Park, Hong In Kim; J Korean Acad Fam Med 1999;20(12):1752-1760. Published online December 1, 1999

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Background
: Assessment of aerobic capacity(VO₂max) is one of the essential components in exercise prescription for health promotion and maintenance. This study was conducted to compare the validity of four exercise tests to assess aerobic capacity in young adult male subjects by comparing them to the values measured from maximal ergometer exercise test(criterion VO₂max).

Methods : twenty young healthy adult males(M±SD=21.1±1.5 years) volunteered as subjects. Criterion VO₂max was calculated and printed out automatically by computerized analysis system of expired air samples collected during maximal ergometer exercise test. VO₂max was estimated for each subjects from heart rate at submaximal workloads on the cycle ergometer using the Åstrand-Rhyming nomogram(A/R) and Fox protocol(FOX) and the computerized multiple extrapolation method (XTP). The score got from Harvard step test(H/S) was used to compare the validity. The validity of the procedures was based on the evaluation of the predicted VO₂max (from A/R, FOX, XTP, and H/S) versus the criterion VO₂max via the calculation of constant error(CE=mean difference for predicted minus criterion VO₂max), r value, standard error of the estimate[SEE=SD-(1-r²)1/2], total error[TE=(∑(predicted VO₂max ? criterion VO₂max)²/n)1/2].

Results : In relation to criterion VO₂max, the XTP and A/R underpredicted (XTP : 40.8 ml/kg/min SD = 4.1; A/R: 37.3 8 ml/kg/min SD = 5.0) and the H/S and FOX overpredicted(H/S: 48.0 8 ml/kg/min SD = 5.9; FOX 46.3 8 ml/kg/min SD = 5.5). Dunnett post-hoc procedures revealed that there were significant(P<0.05) mean differences(CE) for VO₂max from A/R versus criterion. The validity coefficients for VO₂max derived from XTP, H/S, A/R, and FOX were 0.68,0.53,0.50, and 0.49, respectively. TE of the XTM, FOX, H/S and A/R, which accounts for the effects of both the CE and SEE, were5.73,6.13,6.75, and 8.87, respectively.

Conclusion : These results suggest that the XTP is recommended first for estimation VO₂max in young adult males. It is also considered that further studies about female and other age groups are necessary.

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The effects of different exercises on regional bone density in young adult female athletes.: Chan Hee Song, Kyung Soo Kim, Whan Seok Choi, Sun Myeong Ock; J Korean Acad Fam Med 1998;19(8):642-651. Published online August 1, 1998

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Background
: Previous studies have suggested that regular exercise may increase bone mineral density. However the effects on bone mineral density are different depending on the types of exercises and recent studies on the effects of different exercises on bone mineral density are insufficient. This study was conducted to assess the effects of 2 different exercises(Judo, Taekwondo) and physical fitness(back muscle strength, grip strength, broad jump, vertical jump, flexibility, sit ups) on regional BMD.

Methods : Subjects were healthy adults female volunteers aged 19 to 22 years and consisted of eight Judo athletes, twelve Taekwondo athletes, and eight nonathletic controls. We measured their bone mineral density of lumbar spine, femur neck, femoral greater trochanter, Ward's triangle, femoral shaft and distal radius using dual exergy X-ray absorptiometry and assessed their physical fitness. We investigated the mean differences of regional bone mineral density between the groups and the relationships between physical fitness and regional bone mineral density.

Results : ANCOVA revealed that there were significant differences in the regional bone mineral density between the groups. The Judo athletes group had significantly higher bone density of greater trochanter, femoral shaft, distal radius, femoral neck and lumbar spine that the control group and had significantly higher bone density of greater trochanter, femoral shaft and distal radius than the Taekwondo athletes group. There were no significant differences of bone density in all the regions between the Taekwondo athletes and the control groups. Partial correlation coefficients between the back muscle strength and the bone density of Ward's triangle, greater trochanter, distal radius, femoral neck, femoral shaft, and lumbar were 0.581, 0.570, 0.526, 0.502, 0.424 and 0.418, respectively(P<0.05). Correlation coefficients between the broad jump and the bone density of femoral neck, greater trochanter, and femoral shaft were 0.577, 0.539 and 0.457, respectively(P<0.05). Correlations of the grip strength, flexibility, sit ups and vertical jump with bone density of all regions were not high(r≤0.5).

Conclusion : Different types of exercises showed different effects of bone density. The back muscle strength among the physical fitness factors was considered to be the most important predictor of bone density. In the future, further studies are necessary for the effects of other exercises on bone density.

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Relations between peri and postmenopausal symptoms and vertebral bone mineral density.: Kyung Soo Kim, Sun Myeong Ock; J Korean Acad Fam Med 1997;18(8):844-854. Published online August 1, 1997

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Background
: Menopause leads to rapid bone loss, mainly as a result estrogen deficie-ncy and peri and postmenopausal symptoms are related with estrogen deficiency. We inve-stigated the relationship between peri and postmenopausal symptoms and vertebral bone mineral density(BMD).

Methods : Study subjects were women aged above 40 years underwent a vertebral bone density measurement with dual energy x-ray absorptiometry(DEXA). We examined the re-lationship between the menopausal symptoms by Kupperman index including vasomotor symptom and vertebral BMD in 74 perimenopausal and 205 postmenopausal women.

Results : On the basis of vertebral fracture threshold, 169 subjects were osteoporotic group and the others were nonosteoporotic group. Menopausal index was significantly high in osteoporotic group. And the osteoporotic one also complained of vasomotor symptom more severely. Theses findings were more definite during perimenopausal and early post-menopausal periods than late period.

Conclusion : The results suggest that menopausal symptoms of peri and early menopau-sal period are significantly related with vertebral bone loss and helpful in predicting the vertebral osteoporosis.

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Predictive factors influencing women to take cancer screeing test in a local area.: Kyung Soo Kim, Son Ho Lee, Kyung Mee Kim, Ho Cheol Shin, Yong Chul Kim; J Korean Acad Fam Med 1996;17(12):1442-1449. Published online December 1, 1996

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Background
: Death and disability associated with breast and cervical cancer can be re-duced by early detection and treatment. Screening tests are readily available, and disability and death associated with those conditions can be lessened through early detection and treatment.

Methods : The study populations were patients who were between the ages of 20 and 65 and visited the department of Family Practice of Uijongbu St. Mary's Hospital from Janu-ary 1, 1994 to April 30, 1994. We examined characteristics of the women that might affect their likelihood of receiving the various screening tests. The characteristics included demo-graphic and reproductive health variables associated in the literature with bresat cancer-and cervical caner.

Results : The overall rates of screening reported by the omen interviewed were 67.8 percent for a Pap test and 13.8 percent for a mammography. The strong predictors for receiving a Pap test or a pelvic examination were age older than 40, living with a partner and taking a regular health screening test.

Conclusion : The prevalence of women ever having undergone a Pap test was high in middle age, those living with a partner, and those taking a regular health screening test and was low in more educated women. The prevalence of omen ever having undergone a mammography was low in regular drinkers.

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Comparison of Body Composition Assessment by Hydrodensitometry, Skinfolds, Imedance and Near-infrared Interactance in Young Adult Males: Kyung Soo Kim, Sun Myeong Ock, Chan Hee Song, Eun Suk Park, Jae Koo Lee, Hong In Kim; J Korean Acad Fam Med 1996;17(11):1186-1186. Published online November 1, 1996

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SEMINAR / Seminar 1 / Problems of new immunization schedule and its solution.: Young Sik Kim, Yoon Mi Song, Cheol Hwan Kim, Kyung Soo Kim; J Korean Acad Fam Med 1996;17(11):978-981. Published online November 1, 1996

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Reliability and Validity of Submaximal Cycle Ergometer Test in estimating aerobic capacity.: Kyung Soo Kim, Son Ho Lee, Kyung Mee Kim, Sun Myeong Ok, Chan Hee Song, Hong In Kim; J Korean Acad Fam Med 1996;17(3):260-268. Published online March 1, 1996

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Background
: Measurement of VO2max(aerobic capacity) in one of the essential components in exercise prescriptionn for health promotion and maintencance, but direct measurement of VO2max is often not feasible in primary care settings. Therefore, many procedures for estimtion of VO2max have been developed. This study was conducted to determine the reliability and validity of submaximal cycle ergometer test in estimating aerobic capacity in young adults.

Methods : 20 make medical sutdents, mean age 23.5 years(range,22~25 years) were recruited as volunteers for this study. 5 students who had smoking history or mild anemia anemia were excluded in the analysis. submaximal cycle ergometer test was conducted 2 times over two-week period to examine the text0retest reliabilty of it. Validity was assessed by studying the relationships of VO2max estimated by submaximal cycle ergometer exercise test to VO2max measured by maximal cycle ergometer exercise test. All data were analysed by using the statistical Analysis System package.

Results : 1) differences between timel and time 2 were assessed by using paired t-test and there was no significant difference between them, and the pearson correlation between the measurements of aerobic cpacity by submaximal exercise test assessed at each visit was 0.72 and 0.82 when expressed in l/min and ml/kg/min. respectively.(P<0.01) 2) The pearson correlation between VO2max estimated by submaximal cycle ergometer test and VO2max measured by maximal ergometer test was 0.69 and 0.73 when expressed in ml/kg min and l/min, respectively.(P<0.01) 3) There was positive relationship between VO2max and muscle power, flexibilty and vertical jump and negative relationship between VO2max and sum of skin fold and lipid profile. Statistical significance was obsereved only relationships between VO2max and each of flexibility, muscle power(rt) and serum total cholesterol.

Conclusion : It is suggested that submaximal cycle ergometer test can provide a good estimate of VO2max determined by maximal ergometer test in young, well-motivated subjects. Further studies for other age groups and female subjects are also necessary.

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(Reliability and Validity of Submaximal Cycle Ergometer Test in estimating aerobic capacity): Kyung Soo Kim, Son Ho Lee, Kyung Mee Kim, Sun Myeong Ok, Chan Hee Song, Hong In Kim; J Korean Acad Fam Med 1995;16(11):265-265. Published online November 1, 1995

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Postmarketting surveillance for nonsteroidal antiinflammatory drugs.: Young Sik Kim, Hye Soon Park, Kyung Soo Kim, Ho Sheol Shin, Byung Sung Kim, Whan Suk Choi, Shin Whui Lee, Tee Jin Park; J Korean Acad Fam Med 1995;16(9):600-607. Published online September 1, 1995

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Background
: NSAIDs is one of the most commonly used drugs in primary care. Although they are generally well tolerated, they have been implicated in some side effects. The purpose of this study is to investigate the incidence and features of adverse reactions associated with nonsteroidal antiinflammatory drugs.

Methods : We tried post marketting surveillance for NSAIDs in the department of Family Medicine among five medical centers from Feb. 1994 to Oct. 1994. 268 patients who have NSAIDs at least one week to manage degenerative joint disease, headache and other diseases were included. We monitored adverse reactions regularly at interval 1,2,3 and 4th week after use of NSAIDs. We analized the incidence patterns using Chi-square test.

Results : The adverse reactions of NSAIDs were edema(13.6%), abdominal pain(12.8%), dyspepsia(10.1%), flatulence(2.7%), constipation(2.2%) and diarrhea(1.6%) in order. The incidence rate of edema is significantly higher in female as 16.6% than in male as 3.6%(p<0.05), and higher in old ages(≥ 50 years) as 19.4% than in younger ages(<50 years) as 8.2% (p<0.05). The incidence rate of abdominal pain is significantly higher in group who had gastritis as 23.4% than group who had not gastritis as 11.9%(p<0.05).

Conclusion : The adverse reactions of NSAIDs were edema, abdominal pain, dyspepsia, flatulence, constipation and diarrhea in order. The incidence rate of adverse reactions varied according to sex, age, drugs, and histories of gastritis.

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Anxious and depressive trends of bowel disease.: Im Yu Kim, Chae Gab Lim, Yun Hi Kim, Kyung Soo Kim, Ho Cheol Shin, Eun Sook Park; J Korean Acad Fam Med 1992;13(12):916-926. Published online December 1, 1992

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Background
: Patients with multiple gastrointestinal symptoms are frequently encountered in family practice, and they are categorized ultimately as a functional bowel disease (non-ulcer dyspepsia or irritable bowel syndrome) and an organic bowel disease. This study compared the anxious and depressive trends among three groups of patients with gastrointestinal symptoms mentioned above and healthy control group.

Methods : The patient groups with gastrointestinal complaints were comprised of 239 outpatients (male : 104, female : 135) who visited the department of family medicine or internal medicine, Kangnam St. Mary's Hospital, Catholic Medical College from February to May, 1992. The healthy control group was 144 subjects (male : 101, female : 43) who visited the Preventive Medicine Clinic for routine health check. Patients groups were divided by independent clinical evaluation into non-ulcer dyspepsia group, irritable bowel syndrome group and organic bowel disease group. For the assessment of anxiety and depression we used Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) devised by Zung.

Results : The mean anxiety scores counted by SAS of non-ulcer dyspepsia, irritable bowel syndrome, organic bowel syndrome and control were 41.9±11.5, 38.8±8.3, 40.1±10.1, 33.8±8.3, respectively. All three groups with gastrointestinal complaints showed significantly higher anxious trends than the control group(P<0.05). In males there was no significant difference between each of the symptom groups and the control group, but in females the two symptom groups except the irritable bowel syndrome showed significantly higher anxious trends than the control group(P<0.05).
The mean depression scores by SDS of non-ulcer dyspepsia, irritable bowel syndrome, organic bowel syndrome and control were 46.4±11.2, 41.6±10.9, 44.9±10.5, 40.1±10.1, respectively. The two symptom groups showed significantly higher depressive trends than the control group(P<0.05). In males there was no significant difference between each of the symptom groups and the control group group, but in female the two symptom groups except the irritable bowel syndrome group showed significantly higher depressive trends than the control group(P<0.05).

Conclusion : There was significant difference in anxiety and depression score between bowel disease and health, especially in female patients. This study suggested that anxiety and depression should be considered as important risk factors of bowel disease.

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A study on muscle tension level of headache patients and controls by using EMG biofeedback.: Chae Gab Lim, Jang Ho Park, Suk Ryong Lee, Kyung Soo Kim, Ho Cheol Shin, Eun Sook Park; J Korean Acad Fam Med 1992;13(7):602-609. Published online July 1, 1992

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Background
: By reacting to external stress properly, the human body survives with preservation of homeostasis. But these homeostatic adaptive control systems may be impaired by chronic stress, and readjust to a new abnormal state. After the disappearance of stress, this abnormal readjusted state may persist. Stressors, which change homeostasis, cause various kinds of alteration of psychophysiological phenomena. One of these is muscle tension of our body. Thereupon, comparing basal frontals muscle tension, authors studied persons suffering from tension headache and migraine headache and normal persons in order to facilitate the treatment and diagnosis of the disorders.

Methods : Participants were selected from employees and outpatients in the department of family medicine at St. Mary's hospital, students of Catholic university medical college with a questionnaire about headache. But those suspicious of having organic causes of headache were excluded. Three groups were studied-tension headache, migraine headache and control. The basal frontalis muscle tension was measured by using surface electromyographic biofeedback equipment (model BIOLAB, Autogenic Cyborg)

Results : The basal mean EMG level of the tension headache group was the highest (2.34μV), next was migraine headache group (1.05μV) and the lowest in controls (0.78μV). Differences among the three groups were statistically significant(P<0.0001). The difference in the mean EMG level between tension headache and migraine headache groups was significantly different, and the difference between tension headache and control groups was also significant. However the difference between tension headache and migraine headache groups was significantly different, and the difference between tension headache and control groups was also significant. However the difference between migraine headache group and the control group did not significantly differ in the mean EMG level. Disease type contributed most to the variation in surface EMG levels. The usual factors which affect basal EMG levels such as sex and age etc did not significantly change EMG levels.

Conclusion : The basal mean EMG levels are significantly different between the two headache groups. Even though basal EMG level can vary by examiner, if repeated basal mean EMG levels are ascertained by the same examiner, basal mean EMG levels can be used as an adjunctive diagnostic tool The basal EMG level of the control group can be used as a reference value in treatment of patients with high muscle tension.

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The comparison of quality of life between hypertension patients andnormal control subjects.: Kyoung Mi Park, Hyun Sook Kim, Kyung Soo Kim, Ho Cheol Shin, Eun Sook Park; J Korean Acad Fam Med 1992;13(3):240-245. Published online March 1, 1992

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Background
: Hypertension is a chronic and usually symptomless disease. Studies have shown that the quality of life in persons with undiagnosed hypertension does not usually differ from that in normal control subjects. Nevertheless, many patients who are aware of their condition do not perceive themselves as being in a state of total wellbeing. Therefore, we carried out this study to compare the quality of life between hypertensive patients and normal control subjects.

Methods : Hypertensive patients without complication and another disease visiting the Department of Family Medicine from July to September, 1991. The number of the total respondents was 52.

Results : The quality of life in normal control subjects was higher than that of hypertensive patients(p<0.01). The quality of life in patients with uncontrolled hypertension was lower than that of patients with controlled hypertension or normal control subjects(p<0.01). The quality of life in patients with uncontrolled hypertension was lower than that of patients with controlled hypertension or normal control subjects(p<0.01). The quality of life between patients with controlled hypertension and normal control subjects had no distinct difference.

Conclusion : This study shows that the quality of life of patients with uncontrolled hypertension is statistically lower than that of patients with controlled hypertension or normal subjects. Therefore, anti-hypertensive therapy is effective in increasing the quality of life of patients as well as in reducing the mortality and morbidity from congestive heart failure, renal disease, stroke, and other complications of hypertension.