• Research in Community and Public Health Nursing
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• v.11 no.2
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• pp.486-498
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• 2000

The purpose of this study is to identify health problems and health behaviors of the middle-aged residing in urban areas and to plan and implement health promotion programs based on their health needs. The subjects' age ranged from 30-64 years in 1.040 middle-aged residing in an area of Kangbook-ku in Seoul. The data were collected from September 1998 to February 1999 with structured questionnaire using face-to-face or telephone interviews. The data were analyzed by SPSS-PC+ and identified by $X^2$ test and ANOVA. The results were as follows: 1. 35.4% of the males and 27.8% of the female responded that they were healthy regarding their perceived health status. In the order of chronic illness prevalence in the case of males was hypertension, diabetes, and digestive disorders and. in the case of females, was digestive disorders, hypertension, arthritis, anemia, and diabetes. 2. Male and female's smoking rates were 7.3% and 3.6% each and marked the highest rate of 30 to 40 years: drinking behavior was 66.9% in males and 32.2% in females. 3. The younger males had the worse dietary habits and had the lowest frequency of regular exercise. The older the females were, the more their weight increased. According to the results, health promotion programs by sex are recommended, especially in the target population of 30 to 40 years. and focused on the strategies for promoting self-care and actual health practice: it is strongly suggested that health promotion programs for adolescent and school-aged children before middle aged health behavior begins.

• The Journal of the Korea Contents Association
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• v.11 no.12
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• pp.347-356
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• 2011

The aim of this study was to determine the prevalence of self-assessment halitosis and to offer the basic information that establishes a strategy of effective health promotion and to enhance the quality of life. This study performed a questionnaire survey. The questionnaire was filled out by the 362 adults, who lived in Incheon Metropolitan City from May to July, 2010. The data were analyzed using a Chi-square test in the SPSS version 12.0 program. The prevalence rate of self-assessment halitosis was 24.3%. Hypertension, diabetes, medication and inadequate oral hygiene practice were significantly associated with self-assessment halitosis. Other factors of self-assessment halitosis were older age and occupation. As a result, dental professionals have to investigate a systemic disease history thoroughly. And they have to educate regular checkup of oral health and to perform a continuous feedback. The self-assessment halitosis has a negative influence on mental health and social life, so dental professionals must take into consideration about the halitosis.

• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.693-699
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• 2005

Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes $(3.45\pm0.43g/dL)$ than in non-diabetic patients $(3.64\pm0.36 g/dL)$ (p<0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes $(1.42\pm1.8mg/dL)$ (p<0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r=-0.553, p<0.01) and non-diabetic (r=-0.579, p<0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r=0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) $(153.1\pm80.1mg/dL\;vs\;101.6\pm62.4mg/dL)$ and decreased serum HDL cholesterol $(36.89\pm13.48mg/dL\;vs\;47.00\pm14.02mg/dL,\;P<0.05)$. There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r=0.438, p< 0.05) and non-diabetic (r=0.527, p<0.05) patients. Serum CRP level was negatively correlated with calorie (r= -0.468, p < 0.05), protein (r=-0.520, p < 0.01) and fat intakes (r=-0.403, p < 0.05) in diabetic patients and calorie (r=-0.534, p<0.05) and protein intakes (r=-0.559, p<0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.301-314
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• 1999

To evaluate the ischemic heart disease risk factors and analysis on the its relationship between risk factors and ischemic heart disease on EKG findings in a rural area, We conducted cross-sectional health screening test for 1304 persons aged over 30 years. Blood pressure, total cholesterol, HDL cholesterol, fasting blood glucose, BMI and Waist/hip ratio, smoking data and EKG data were collected. Hypertension was classified by the sixth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure and the cutpoints of hyperlipidemia was used National Cholesterol Education Program. The cutpoint of hyperglycemia was used National Diabetes Data Group and those for obese was 30%. The results obtained were as follows; 1. Prevalence of definitive hypertension was 41.2% in males and 41.6% in females. The prevalence of hypertension showed Increasing tendency according to age increase(p<0.05). 2. Prevalence of hyperlipidemia was 20.6% in males and 20.4% in female. In females prevalence of hyperlipidemia showed increasing tendency according to age increase(p<0.001). 3. Prevalence of obese was 23.4% in males and 28.8% in females. Upper body type was predominant in females, but lower body type was predominant in males. 4. Prevalence of hyperglycemia was 11.0% in males and 12.1% in females. The prevalence of hyperglycemia showed increasing tendency according to age increase(p<0.01). 5. The smoking rate was 63.7% in males and 2.6% in females. 6. On the EKG findings, the prevalence of myocardial ischemia and myocardial infarction was 6.7% in males and 7.5% in females. 7. The prevalence of Ischemic heart disease was higher in hypertension than normal in females and higher in obese than normal in males. In males and females the prevalence of ischemic heart disease was higher in hyperglycemia than normal and higher in upper body type than lower body type. But there is no statistical association among them.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.585-590
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• 2003

Purpose : This study is designed to determine the prevalence of cardiovascular autonomic neuropathy and its relationship to risk factors in adolescents with diabetes mellitus(DM). Methods : Ninety-two diabetic patients(80 with type 1 DM and 12 with type 2 DM), ranging from eight to 26 years of age, were studied for cardiovascular autonomic function, and the relationship to age, duration of diabetes, glycated hemoglobin(HbA1c), urinary albumin excretion, and the presence of diabetic retinopathy and abnormal nerve conduction velocities(NCV) were analysed. Autonomic function was assessed by measuring heart rate variation during valsalva manoeuvre, deep breathing and standing from a lying position(30 : 15 ratio), and postural hypotension. Results : Among patients with type 1 DM, 22.5% had early, 8.7% had definite, and 1.3% had severe autonomic dysfunction, and among patients with type 2 DM, 16.7% had early, 8.3% had definite, and 8.3% had severe autonomic dysfunction. On logistic regression analysis including both type 1 and type 2 diabetic patients, the age of the patient(OR=1.133(1.003-1.279), P<0.05) and duration of diabetes(OR=1.148(1.009-1.307), P<0.05) significantly predicted cardiovascular autonomic dysfunction while HbA1c, blood pressure, urinary albumin excretion, and presence of diabetic retinopathy and abnormal NCV did not. The valsalva ratio was borderline or abnormal in 31.5% of patients, the heart rate variation on deep breathing in 41.3%, the 30 : 15 ratio in 14.1%, and postural hypotension in 9.8% of patients. The valsalva ratio and the heart rate variation on deep breathing significantly predicted cardiovascular autonomic dysfunction, but the 30 : 15 ratio and postural hypotension did not. Conclusion : Cardiovascular autonomic dysfunction was found in 32.6% of diabetic patients and 10.8 % of patients had definite or severe involvement. The risk of cardiovascular autonomic dysfunction increased with the patient's age and the duration of DM. This study suggests that the valsalva ratio and the heart rate variation on deep breathing are the most useful tests in evaluating the cardiovascular autonomic function in children and adolescents with DM.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.2
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• pp.103-108
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• 2011

Objective: To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups. Methods: Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/$m^2$, and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes. Results: There was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups ($p$ <0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups ($p$ <0.02). Conclusion: Non-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.108-115
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• 2012

Purpose: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. Materials and Methods: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. Results: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. Conclusion: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.465-473
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• 1995

Background: The prevalence of pulmonary tuberculosis has decreased progressively after the control of the tuberculosis began as national control. But as diabetes, malignancy, immunodeficiency disease recently tend to be increased, the tuberculosis become to the important national health problem. So, this study was designed to observe the state and the change of the prevalence and the clinical status of pulmonary tuberculosis for recent 10 years at one women's university. Method: We retrospectively investigated the epidemiology and the clinical status of 612 patients who were registered at the Ewha Womans University Health Center by analyzing records from 1983 to 1992. Results: 1) The prevalence rate had been steadily decreased from 0.63% in 1983 to 0.11 % in 1992. The prevalence of freshman and the incidence rate according to the entrance year while in the university significantly decreased since 1989. 2) In classifying by registered source, 45.6% of students were detected by annual periodical health examination, 34.5% by entrance physical examination, 12.0% by hospital, 5.4% by health center clinic, 2.5% by reentrance physical examination, sequentially. 3) The students with past history of tuberculosis were 70(11.4%) and 61(10%) suffered from pulmonary tuberculosis. The patients with family history of tuberculosis were 142(23.3%). 4) There were 530(86.6%) with minimal disease, 79(12.9%) with moderate and only 3(0.5%) with far advanced, when classified by the severity of disease. 5) The initial symptoms were mild breathing difficulty in 30.1%, sweating in 14.9%, fatigue in 14.3%, febrile sense in 11.7%, hemoptysis in 8.2%, sequentially. 6) The duration of treatment was $10.6{\pm}3.6$ months in mild group, $14.9{\pm}5.2$ months in the moderate group(P<0.05). 7) The side reactions of the drug were GI trouble in 7.2%, hepatitis in 1.8%, skin rash in 0.8% and streptomycin side in used patients in 9.1%. Conclusion: The prevalence of pulmonary tuberculosis among the students in one women's university was significantly lower than that of university students and 20-24 year-old age group announced in tuberculosis survey on a national scale, and significantly decreased since 1989. The treatment effect was desirable in student's group managed by university health center.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.167-182
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• 2005

Objectives: This study was performed to investigate the prevalence of knee osteoarthritis according to the criteria of diagnosing knee osteoarthritis in rural women and the factors related with this disease. Methods: The data obtained from 200 women older than 40 years of age residing in 5 Ri's in Goryeong-gun. Gyeongsanbuk-do by random cluster sampling from September to October 2002. Knee osteoarthritis was determined positive according to the Kellgren and Lawrence classification and knee pain. Results: Among these subjects, 71.0% showed more than grade 2 in radiologic finding and the rate of knee pain according to the survey was 67.0%. The rate of subjects meeting the criteria of knee osteoarthritis was 54.0%. According to univariate analysis, the prevalence of knee osteoarthritis increased with age and those farming people and people working in household industry was significantly high at 58.9% compared with others. The prevalence of knee osteoarthritis showed a significant relationship with the family history and past history of knee injury and knee surgery(p<0.01), and diabetes mellitus(p<0.05). The score of ADL was significantly different in the subjects with knee osteoarthritis compared with normal group(p<0.05). When the presence of knee osteoarthritis and the period of the life style of seating down on the floor were compared, a significant difference was present between the osteoarthritis group and normal group. As for metabolic factors, the blood sugar level, bone density, and body mass index(BMI) were significantly different in the osteoarthritis group compared with normal group. When multiple logistic regression analysis was performed with the presence of knee osteoarthritis as the dependent variable, the prevalence of knee osteoarthritis was significantly affected by older age, subjects farming or working in household industry, the history of knee injury, the history of surgery, higher blood sugar level, and higher BMI. Conclusions: These subjects need an intervention through self-care programs such as exercise for preventing osteoarthritis, weight control programs, other exercise programs strengthening knee joints, and guidelines when working in vinyl houses.

• Health Policy and Management
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• v.19 no.3
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• pp.92-108
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• 2009

This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.