Korean Journal of Family Medicine

"Sangyeoup Lee"

Case Report

Pyogenic Liver Abscess Following Acupuncture and Moxibustion Treatment: Eun Jung Choi, Sangyeoup Lee, Dong Wook Jeong, Young Hye Cho, Su Jin Lee, Jeong Gyu Lee, Yun Jin Kim, Yu Hyun Yi, Ji Yong Lim; Korean J Fam Med 2013;34(5):364-368. Published online September 26, 2013; DOI: https://doi.org/10.4082/kjfm.2013.34.5.364

Abstract
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Acupuncture treatment is generally regarded as a relatively safe procedure. However, most procedures have some complications and acupuncture treatment is no exception. Reported complications of acupuncture treatment were mostly mild or temporary symptoms, but certain severe adverse effects were also observed. We report here for the first time a case of liver abscess following acupuncture and moxibustion treatment.

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Zen Nihon Shinkyu Gakkai zasshi (Journal of the Japan Society of Acupuncture and Moxibustion).2017; 67(1): 29. CrossRef
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Evidence-Based Complementary and Alternative Medicine.2014;[Epub] CrossRef

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Brief Communication

The Impact of Bladder Distension on Blood Pressure in Middle Aged Women: Eun Jung Choi, Dong Wook Jeong, Jeong Gyu Lee, Sangyeoup Lee, Yun Jin Kim, Yu Hyone Yi, Young Hye Cho, Sun Ju Im, Mi Jin Bae; Korean J Fam Med 2011;32(5):306-310. Published online July 28, 2011; DOI: https://doi.org/10.4082/kjfm.2011.32.5.306

Abstract
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Background

The purpose of the present study was to investigate the relation between the extent of bladder distention and the rise of blood pressure in middle aged women.

Methods

In a cross-sectional, descriptive observational study, we obtained data from 172 middle aged women at a health promotion center of Pusan National University Hospital. We measured duration of urine-holding as the degree of the extension of bladder distention. Blood pressure was measured twice while holding urine and immediately after urination. Urine holding with full bladder was confirmed by abdominal ultrasound.

Results

Difference in systolic blood pressure was 4.2 ± 10.7 (P < 0.001), and that in diastolic blood pressure was 2.8 ± 7.7 mm Hg (P < 0.001) between holding urine and immediately after urination. There was no significant correlation between the urine-holding duration and differences in systolic and diastolic blood pressure.

Conclusion

Our findings suggest that systolic and diastolic blood pressure is increased by urine-holding at least 3 hours after the last urination in middle aged women. Thus in practice, blood pressure should be measured after the bladder is emptied.

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Original Articles

The Relationship between Self-Efficacy and Body Weight Reduction after Educational Program for Health Care.: Seung Jun Lee, Yun Jin Kim, Sangyeoup Lee, Jeong Gyu Lee, Young Joo Kim; Korean J Fam Med 2010;31(4):294-301. Published online April 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.4.294

Abstract
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Background
Obesity is one of the health problems with high risk of metabolic and physiologic morbidity worldwide. Obesity increases cardiovascular disease risk and death as well as psychological and emotional health problems. Self-efficacy and physical self-efficacy are important evaluation tools for successful diet and exercise in obesity diet practice and it is directly associated with health behaviors. This study conducted to evaluate the effect of weight loss on self-efficacy and life quality.Methods: The 39 adults who joined in weight control program in one public health center were recruited into this study. Quality of life, depression scale, anxiety scale, self-efficacy and physical self-efficacy were examined. Also physical performance ability and weight and lipid profile were examined. Statistical analysis obtained by SPSS.Results: Quality of life and anxiety scale were significantly diminished in obese subjects than non-obese subjects. Quality of life was increased after weight control program in obese subjects. Physical self-efficacy was improved in weight reduction group with much more than 5% of initial weight.Conclusion: Weight reduction has positive impact on psychological aspects in obese subjects. Therefore, we should be more concerned about psychological and functional aspect of obese individuals during weight control treatment.

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Korean Journal of Adult Nursing.2020; 32(4): 421. CrossRef

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A Randomized Controlled Trial of SMS Text Messaging versus Postal Reminder to Improve Attendance after Lipid Lowering Therapy in Primary Care.: Sung Ja Cho, Young Sik Kim, Ho Cheol Shin, Eun Ju Sung, Dae Hyun Kim, Sangyeoup Lee, Tae Hee Jeon, Yun Jun Yang, Chung Hwan Cho, Hee Cheol Kang, Yoo Seock Cheong; Korean J Fam Med 2010;31(4):284-293. Published online April 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.4.284

Abstract
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Background
In the primary care setting, compliance with lipid lowering therapy was relatively low. In order to compare the efficacy of a short messaging service (SMS) text messaging and postal reminder as means of improving attendance rates during the first 24 weeks of lipid-lowering therapy, a randomized controlled trial of 918 patients from 19 family practice clinics was conducted between February 2003 and June 2006. Methods: Patients were randomly assigned into 3 groups: SMS (327), postal (294),and control (297) group. To ascertain attendance rates, patients were followed up at 24 weeks after their treatment. Reminders were sent at 16 weeks from the coordinating center. Results: Overall attendance rate was 74.1%. This differed between groups, with 76.1% attendance for the SMS group, 73.5% for the postal group, and 72.4% for the control group. According to a multivariate analysis, the SMS group had a significantly higher attendance rate (Odds ratios [OR] 1.48; 95% confidence interval [CI], 1.01 to 2.16) than the control group, but the postal group (OR, 1.15; 95% CI, 0.79 to 1.69) did not. Moreover, the cost per attendance for the SMS reminder (155 Korean Won [KRW]) was much lower than that for the postal reminder (722 KRW). Conclusion: SMS reminder may be more cost saving method to improve the attendance rate compared with the postal reminder.

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The Role of C-reactive Protein as a Inflammation-related Factor in Metabolic Syndrome.: Jeon Su Park, Yun Jin Kim, Jeong Gyu Lee, Young Joo Kim, Sangyeoup Lee, Hong Gi Min, Byung Mann Cho; Korean J Fam Med 2009;30(6):449-456. Published online June 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.6.449

Abstract
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Background
The metabolic syndrome has been known as the cluster of insulin resistance, dyslipidemia, hypertension, and abdominal obesity. There have been many studies about the infl ammatory role in atherosclerosis and cardiovascular diseases, also. We aimed to elucidate the role of high sensitivity C-reactive protein (hs-CRP) as a infl ammation-related factor in metabolic syndrome in Korean adults by correlation and factor analysis. Methods: A cross sectional study was carried out in 1,512 men and 1,836 women (over 20 years old) who had an examination at a center for health promotion of an university hospital from May 2004 through March 2005. The NCEP-ATP III definition and Asian-Pacific adjusted criteria were used to obtain the metabolic syndrome group. And we evaluated the role and gender difference of hs-CRP in metabolic syndrome by correlation and factor analysis.Results: In women, hs-CRP was statistically correlated with most metabolic variables, especially insulin resistance. In factor analysis, 3 factors (obesity, blood pressure, and insulin resistance) were obtained in men and 4 factors (obesity, blood pressure, insulin resistance, and dyslipidemia) in women, respectively. In women, hs-CRP was a part of dyslipidemia factor.Conclusion: In factor anaylsis of metabolic syndrome factors with hs-CRP, hs-CRP was not a signifi cant factor in men, but was included as a part of dyslipidemia factor in women.

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Health Behavior and Metabolic Syndrome.: Jeong Dae Oh, Sangyeoup Lee, Jeong Gyu Lee, Young Joo Kim, Yun Jin Kim, Byung Mann Cho; Korean J Fam Med 2009;30(2):120-128. Published online February 10, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.2.120

Abstract
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Background
Life style has been shown to improve risk factor comprising the metabolic syndrome. Metabolic syndrome is prime candidate for lifestyle modification utilizing the tools of exercise, nutritional therapy so on. Therefore, we examined the prevalence of metabolic syndrome according to health behaviors. Methods: The 1,240 adults were recruited into this cross-sectional study. Subjects examined body mass index, waist circumference, blood pressure, lipid profile. Medical history was reviewed and daily calorie intake examined by food frequency questionnaire. Six healthy behavior-sleeping hours, smoking, drinking, exercise, calorie intake and boey weight of subjects were examined. Each heathy behaviors were categorized as a three groups. Metabolic syndrome were diagnosed by ATP III criteria. Results: The study subjects were consisted of 57.1% men and 42.9% women. The prevalence of metabolic syndrome was 14.3%. The prevalence of metabolic syndrome was lower in group with good healthy behaviors. Subjects with more good healthy behaviors had lower prevalence of metabolic syndrome than with less good healthy behaviors(0, 50.0%; 1, 41.0%; 2, 30.6%; 3, 13.8%; 4, 8.5%; 5, 5.3%; and 6, 4.3%). Relative to subjects with high good health behavior score, those with low good health behavior score were at significantly increased risk of metabolic syndrome (odds ratio=4.25, 95% CI 2.97-6.08). Conclusion: Subjects with greater good healthy behaviors had a substantially lower risk of being diagnosed with the metabolic syndrome compared those with lower good healthy behaviors. This finding suggests that lifestyle modification may be appropriate as a first-line intervention to metabolic syndrome.

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Relations of Serum gamma-glutamyltransferase Levels to Incidence of the Metabolic Syndrome.: Shin Woong Oh, Jeong Gyu Lee, Min Seok Kim, Dong Wook Jung, Young Joo Kim, Sangyeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2008;29(11):838-843. Published online November 10, 2008

Abstract
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Background: The metabolic syndrome is a cluster of risk factors for cardiovascular diseases. Recently, serum gamma-glutamyltransferase (GGT) has been suggested as a predictor for development of the metabolic syndrome. Therefore, we investigated the association between serum GGT levels and the incidence of the metabolic syndrome in the Korean healthy adults with normal serum GGT with a 3 year follow-up. Methods: The study subjects consisted of 741 individuals who visited the Center for Health Promotion in Pusan National University Hospital for a medical checkup in 2002 to 2005. Among 741 subjects, 312 were excluded: 71 were positive for HBsAg, 17 were positive for Anti-HCV Ab, 40 showed GGT higher levels than limit of reference range, and 224 had metabolic syndrome. The final subjects were 429 individuals. We measured serum GGT levels, lipid profiles, fasting glucose, blood pressure and their metabolic components. Results: As the quartile of serum GGT increased, 3 year follow-up incidence of the metabolic syndrome was increased. Logistic regression analysis adjusting for sex, age, and alcohol drinking status showed that the odds ratio (95% confidence Interval, P-value) of each GGT quartile was 2.28 (0.58∼9.01, P=0.240), 1.53 (0.36∼6.66, P=0.564), 4.56 (1.08∼19.32, P=0.040), respectively. Conclusion: These results showed that the serum GGT was closely related to the metabolic syndrome. In Korean adults without the metabolic syndrome, the serum GGT levels within normal limit were associated with an increased risk of incident, metabolic syndrome. (J Korean Acad Fam Med 2008;29:838-843)

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Regional Fat Measured by DEXA and Metabolic Risk Factors among Women with Central Obesity.: Jin Seung Kim, Kayoung Lee, Jun Su Kim, Tae Jin Park, Sangyeoup Lee, Young Joo Kim, Yun Jin Kim; J Korean Acad Fam Med 2008;29(7):506-512. Published online July 10, 2008

Abstract
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Background: This study was carried out to determine the usefulness of regional body fat measured by dual energy X-ray absorptiometry (DEXA) by examining the relationship between regional body fat and metabolic risk factors. Methods: A total of 98 women aged 18∼65 years with central obesity (waist circumference ≥80 cm) took the evaluation for metabolic risk factors (blood pressure, fasting glucose, insulin, high sensitive c-reactive protein (hs-CRP), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR)) and the anthropometric measurement, and regional body fat measurement using DEXA. The relationship of regional body fat with the metabolic risk factors, the metabolic syndrome (MS) defined by the International Diabetes Federation and insulin resistance (IR, defined by HOMA-IR≥2.48) were assessed. The analyses were conducted using regression and logistic regression analyses. Results: After adjustment for age and total body fat (%), legs fat (%) was significantly and negatively associated with LDL-C, triglyceride, HOMA-IR, and hs-CRP, while positively with HDL-C. The 1% increase of legs fat was associated with the MS by odds ratio of 0.82 (95% C.I 0.71∼0.96) and with the IR by odds ratio of 0.80 (95% C.I. 0.67∼0.95). Trunk fat (%) was significantly and positively associated with LDL-C, triglycerides, and HOMA-IR. The 1% increase of trunk fat was associated with the MS by odds ratio of 1.32 (95% C.I. 1.03∼1.71) and with the IR by odds ratio of 1.33 (95% C.I. 1.01∼1.77). The ratio of android fat to gynoid fat was significantly and positively associated with LDL-C, triglycerides, glucose, and HOMA- IR, while negatively with HDL-C. The 0.1 increase of the ratio was associated with the MS by odds ratio of 1.66 (95% C.I. 1.07∼2.60). Conclusion: The trunk fat, and legs fat, the ratio of android fat to gynoid fat assessed by DEXA seemed to be useful indicators to predict the metabolic risk factors in women with central obesity. (J Korean Acad Fam Med 2008;29:506-512)

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Social Support, Self-concept and Self-efficacy as Correlates of Adolescents' Physical Activity and Eating Habits.: Dong Hee Kim, In Soon Kang, Sangyeoup Lee; J Korean Acad Fam Med 2007;28(4):292-301. Published online April 10, 2007

Abstract
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Background
Despite growing knowledge of the importance of the management of diet and physical activity in the prevention of obesity in adolescence, a better understanding of social psychological influences could assist efforts in family, school and community settings. Methods: Among the 3,653 adolescents who were randomly selected from seven separate school districts in Busan, 2,938 (83.9%) completed the questionnaire. The students who agreed to participate in this study were given a questionnaire which included social support as the Child and Adolescent Social Support Scale, self-efficacy as the physical self-efficacy questionnaire, self-concept as the Song and Hattie Test, physical activity as a Leisure-Time Exercise Questionnaire and eating habits as the Harris questionnaire. Results: The support from parents, teachers, classmates, close friends and other people in the community predicted the level of adolescents' self-concept and physical activity, while only the support from teachers and other people in the community predicted adolescents' dietary self-efficacy. Adolescents' self-concept and physical activity self-efficacy significantly predicted the level of physical activity. Self-concept and dietary self-efficacy also predicted healthier eating habits. Only the support from close friends predicted adolescents' healthy eating habits. The support from parents, teachers, close friends, classmates and other people in the community predicted the level of physical activity through increasing the level of self- concept or physical activity self-concept. Conclusion: Although adolescents' behavior are ultimately individualized, they are formed through cognitive processes which are affected by social support. These social levels, therefore, should be supportive of adolescents' physical activity and healthier eating habits by providing frequent support and encouragement to establish positive self-concept and self-efficacy.

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Application of Abdominal Circumference Presented by Body Composition Analyzer according to Gender and Body Mass Index.: Sang Do Seo, Sangyeoup Lee, Hong Gi Min, Young Joo Kim, Jeong Ik Hong, Yun Jin Kim; J Korean Acad Fam Med 2006;27(8):612-619. Published online August 10, 2006

Abstract
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Background
: Recently, body composition analyzer has been used widely clinically. Various indirectly measured values of body are calculated without direct measuring. The abdominal circumference that is presented by such instrument may be used for diagnosing abdominal obesity, but the reliable evidence of the accuracy and the validity may be not be enough for application to general population. For this reason, the author investigated the usefulness of automatically produced abdominal circumference for diagnosing abdominal obesity.

Methods : The medical records of 5,555 outpatients who had undergone body composition analysis in a tertiary hospital was collected. The usefulness of the automatically presented abdominal circumference for diagnosing abdominal obesity among general population was investigated.

Results : There was a significant positive correlation between abdominal circumference measured by body composition analyzer and measuring tape in the normal, the overweight, and the obese groups of both gender. But, the results were the same only in females in the underweight group. The most significant difference between the two values were 4.8±5.0 cm in normal male group and -5.7±5.5 cm in female obese group. The difference of the male obese group was lesser than that of the overweight, the normal and the underweight groups. The difference of the male overweight group was lesser than that of the normal group. The difference of the female obese group was lesser than that of the overweight, the normal and the underweight groups. The sensitivity and specificity to detect abdominal obese person among the total subjects was 76.3% and 79.1%, respectively. The specificity was higher in all male and the normal female groups, wheras the sensitivity was higher in the obese and the overweight female groups.

Conclusion : Physicians should confirm the accuracy of abdominal circumference, especially in normal males and obese female group, although the automatically presented value is convenient and reflects the manually measured one very well which is useful to diagnose abdominal obesity.

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Diagnosis-related Characteristics of Microvascular Complications among Patients with Type 2 Diabetes Mellitus.: Ihn Sook Jeong, Gae Suk Gill, Yoo Sun Shin, Yi Soon Kim, Sangyeoup Lee; J Korean Acad Fam Med 2006;27(6):456-462. Published online June 10, 2006

Abstract
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Background
: This study was aimed to investigate the diagnosis-related characteristics of the microvascular complications among patients with type 2 Diabetes Mellitus and to identify the relationship ship between regular check-up and detection of complications of diabetes.

Methods : The study subjects were 63 patients with diabetic microvascular complications. The data were collected with self-administered questionnaire and analyzed with descriptive statistics.

Results : The main motive to identify retinopathy was through 'visiting hospital after having symptoms (58.9%)', and not through regular checkup. The most common symptom of retinopathy was dim dye (84.3%) and the mean duration after diabetes mellitus diagnosis was 6.8 years. The main motive to identify renal complications was through 'visiting hospital after having symptoms and checking for other complications (28.0%)'. The most common symptom of renal complications was edema of face and hands (72.0%) and the mean duration following diabetes mellitus diagnosis was 8.4 years. The main motive to identify neuropathy was through 'visiting hospital after having symptoms (34.8%)', and not regular checkup. The most common symptom of neuropathy was tingling sensation of feet (100.0%) and the mean duration following diabetes mellitus diagnosis was 7.4 years.

Conclusion : Based on the results, we suggest that diabetes complications check-up should be performed simultaneously to make the diagnosis of diabetes mellitus, and that the health care providers could provide them with more opportunities to have such check-ups with standardized complications care guidelines.

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Effect of 8-week Therapy with Rabeprazole on Presenting Symptoms in Korean Patients with Gastroesophageal Reflux Disease.: Yun Jin Kim, Joo Sung Park, Sangyeoup Lee, Hong Gi Min, Young Joo Kim, Sang Han Choi, Hye Mi Jeong; J Korean Acad Fam Med 2006;27(6):449-455. Published online June 10, 2006

Abstract
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Background
: Gastroesophageal reflux disease (GERD) is common in Western civilization and comprises 75% of esophageal diseases. However, there are only few studies of GERD in Korea. The aim of the study was to evaluate the clinical symptoms of GERD in Koreans and the effect of Rabeprazole on the symptoms.

Methods : The study subjects were included 353 patients who were diagnosed endoscopically with reflux esophagitis (316) or non-erosive reflux disease who have complained of intermittent heartburn during the past 3 months or more. All patients received Rabeprazole 20 mg daily for 8 weeks. Symptoms according to 8 symptom categories of GERD were evaluated. Patients recorded the severity of GERD associated symptoms at baseline, 4 weeks and 8 weeks after treatment. Presenting symptoms in Korean, frequency and severity of each symptom was evaluated. Efficacy of Rabeprazole treatment was analyzed.

Results : The most common symptoms of GERD were regurgitation (60.9%), heartburn (52.7%), epigastric pain/ soreness (49.6%) and other epigastric discomfort (47.0%). Symptom severity was rated in order of epigastric pain/ soreness, epigastric discomfort, and heartburn. The proportion of all symptoms, except for heart burn and cough, increased in relation to the severity of endoscopic grading, but the severity of symptoms was not significantly different between subgroups according to endoscopic findings. Symptoms, except for hoarseness, globus sensation and cough, significantly improved in 4 weeks after treatment. Cough did not improve after 4 weeks irrespective of smoking status, All symptoms significantly improved after 8 weeks.

Conclusion : Regurgitation was more common, and epigastric symptoms were more severe than heartburn in Koreans. The 8-week Rabeprazole treatment was effective on all symptoms associated with GERD.

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Validity and Reliability of Self-Report in Cancer Screening.: Ihn Sook Jeong, Yoon Jin Kim, Sangyeoup Lee, Jin Ho Chun; J Korean Acad Fam Med 2006;27(4):302-312. Published online April 10, 2006

Abstract
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Background
: The study was aimed to examine the validity and the reliability of self-report of gastric cancer screening (endoscopy or upper GI), mammography, and Pap smear.

Methods : The study subjects for validity included those who had undergone 276 endoscopies or UGIs, 127 mammograms, and 125 Pap smears performed at a health promotion center of P and I university hospital during January 1, 1999 to June 30, 1999 and January 1, 2002 to June 30, 2002. The study subjects for reliability included those who had undergone 86 endoscopies or UGIs, 31 mammograms, and 33 Pap smears who went through two surveys. The data was collected by mail or telephone interview. We calculated the sensitivity of self-reports by comparing the self-report and the laboratory results as a gold standard, and the agreement between repeated reporting.

Results : The sensitivities based on the test year were 49.3% for gastric cancer screening, 56.7% for mammography, and 53.6% Pap smear, and the sensitivities on the test month were 39.1%, 45.7%, and 46.4%, respectively. The agreement between the two self-reporting on the test year were 59.6% for gastric cancer screening, 67.7% for mammography, and 63.6% Pap smear, and the agreement on the test month were 82.3% for gastric cancer screening, 74.2% for mammography, and 72.7% for Pap smear.

Conclusion : Self-report alone may not provide accurate or reliable data on the cancer screening compliance. It is recommended to utilize other objective data for cancer screening. And it would be helpful to utilize a memo- book as a reminder to screen for cancer in order to enhance the validity and the reliability of self-report.

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Review

Health Literacy: Barrier to Optimal Health Care.: Sung Soo Kim, Sangyeoup Lee; J Korean Acad Fam Med 2005;26(6):313-317. Published online June 10, 2005

Abstract
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The recent announcement by the Korean Educational Development Institute (KEDI) took many by surprise. According to the KEDI, unlike general literacy rate, reading literacy rate (38%) among Koreans which is an individual's ability to understand the information we face on daily base such as directions on prescribed medication ranked at the bottom of all Organization for Economic Cooperation and Development (OECD) member countries. If we accept it as it is, it raises serious questions about Koreans' abilities to read, comprehend, and process necessary information required of functioning properly in the society. Furthermore since the information we get in the medical settings is usually more difficult to understand than other basic information we face in our daily lives, it may be assumed that health illiteracy among Koreans could be much higher and that the ramifications of it would be very much costly. Despite this seriousness of the reading illiteracy among Koreans, to the best of our knowledge, no attempts have been made to address and determine the prevalence of health illiteracy and relate it to the public health educational issue. More specifically, the effectiveness of health education materials has never been analyzed in this regard for the improvement of health education in Korea. The purpose of this article is to introduce a new concept of health literacy to the Korean public by reviewing the existing studies in the West and encourage researchers in the public health education field to look at the concept of health literacy as one of the possible strategies to design and develop more effective health education campaigns in Korea.

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Original Article

The Correlation between Vitamin C Intake and Plasma High-Sensitive C-reactive Protein Concentration.: Jung Gyu Lee, Sangyeoup Lee, Hong Gi Min, Yong Joo Kim, Sang Han Choi, Yun Jin Kim; J Korean Acad Fam Med 2004;25(4):314-321. Published online April 10, 2004

Abstract
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Background
: There are several reports that vitamin C is one of antioxidants and can be used to protect cardiovascular diseases. Inflammation plays a major role in atherosclerosis, and the measurement of inflammatory markers such as high-sensitivity C-reactive protein (hs- CRP) may provide methods for risk prediction and reveal independent risk factors of cardiovascular diseases. The purpose of our study was to assess the correlation between vitamin C intake and plasma hs-CRP concentration.

Methods : The study subjects consisted of 2,012 individuals who underwent periodic health examination in a university hospital in Busan from June 2002 to January 2003. The subjects were questioned concerning their past medical history, alcohol intake, smoking status, physical activity. Body mass index, abdominal circumference, blood pressure, fasting glucose, lipid profile, general blood test, and hs-CRP were measured. The exclusive responsible dietitian evaluated the average calorie intake and vitamin C intake by food frequency questionnaire. To quantify the correlation between vitamin C intake and plasma hs-CRP concentration, Pearson correlation coefficient and Spearman correlation coefficient were presented.

Results : The vitamin C index (r=-0.051, P＜0.05) and the vitamin C intake per calorie intake (r=-0.075, P＜0.01) showed a significant correlation with the plasma hs-CRP level. The vitamin C intake and the vitamin C intake per calorie intake were significantly correlated with the plasma hs-CRP level after adjusting for sex, age, body mass index and smoking status.

Conclusion : These findings suggest that there was a significant correlation between the vitamin C intake and the hs-CRP concentration. Therefore, inflammatory status is higher in a person who takes small amount of vitamin C than a person who takes it plentifully. The former is presumed to have a higher risk of cardiovascular diseases thereafter.

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Case Report

A Case of Porphyria Presented During Management of Acute Upper Respiratory Infection.: Sang Do Seo, Sangyeoup Lee, Hong Ki Min, Young Ju Kim, Sangan Choi, Yun Jin Kim; J Korean Acad Fam Med 2004;25(1):59-65. Published online January 10, 2004

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A 34-year old woman visited the hospital complaining severe general pain which had onset on the way of improvement of sore throat, cough with sputum as symptoms of acute upper respiratory infection for 3 days. The facts that her younger sister also had a history of porphyria and the color of the patient's urine changed to dark black after it had exposed to sunlight made us to rule out porphyria strongly. Therefore, we measured the level of δ-ALA and porphobilinogen in the collected urine during 24 hours, and confirmed her diagnosis as acute intermittent porphyria. The SIADH was complicated and the sleep disturbance, disorientation and hallucination onset during the hospital days. She had taken high dose dextrose IV and hematin IV therapy for porphyria and improved gradually. Therefore, authors et al. report a case of acute intermittent porphyria with various clinical symptoms on the way of treatment of upper respiratory infection as well as review the previous literatures.

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Original Article

Change of Body Weight and Body ComPosition after Smoking Cessation in Males.: Sung Ryul Ahn, Sangyeoup Lee, Hong Gi Min, Sang Han Choi, Young Joo Kim, Yun Jin Kim; J Korean Acad Fam Med 2003;24(11):994-1002. Published online November 10, 2003

Abstract
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Background
: There are very few studies on change in body composition after smoking cessation. The purpose of our study was to assess the change in body composition as well as body weight after smoking cessation in men.

Methods : The subjects were 203 men who had received health examination from May in 2000 to April in 2001 on their first visit, and then from May in 2001 to May in 2002 on their second visit, at the department of family medicine of a university hospital. They were divided into groups of non-smokers, current smokers, and former smokers by smoking status. Their past medical history, obesity indexes, smoking status, physical activity, and nutrition intake were reviewed. Body composition of the study subjects was assessed by bioelectrical impedance analysis.

Results : After adjustment for age, nutrition intake, and physical activity as confounding factors, former smokers' body weight was significantly increased by 1.8±0.4 kg on second visit compared to non-smokers and current smokers. There was a significant difference in body muscle change between first and second visit, but not in body fat change among former smokers. Former smokers' body fat and muscle were significantly increased by 0.9±0.3 kg and 0.8±0.4 kg, respectively, compared to non-smokers. Former smokers' waist circumference was significantly increased by 2.5±0.7 cm on second visit compared with non-smokers and current smokers.

Conclusion : In former smokers, body weight was increased by 1.8 kg after smoking cessation, which was attributed to increase of body muscle as well as body fat. Compared with non-smokers, former smokers' body muscle and fat were significantly increased on second visit.

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Review

Therapeutic Heat and Cryotherapy in Family Medicine.: Hyun Kwak, Sangyeoup Lee, Sang Beom Kim; J Korean Acad Fam Med 2003;24(10):877-883. Published online October 10, 2003