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.

Breaking bad news to patients with an advanced cancer is a difficult task for physicians. Some strategies can be used when breaking bad news to patients with advanced cancer. However, many doctors were not trained sufficiently. 43-year old male complaining of general weakness and melena was diagnosed as an advanced gastric cancer with hepatic metastasis. We could deliver this bad news to the patient and his family step by step. Honest discussion allowed patient to be reassured about many points of concern and helped them to be calmer and to plan and readjust hopes and aims. Bad news cannot be broken gently, but it can be given in a sensitive manner and at the individual's pace. Sometimes doctor's own anxiety can be barrier to tell the truth. When we give the information, we always keep in mind about the respect for truth, the patient's rights, the duty to inform, maintaining hope, and the sanctity of the individual contract between patient and doctor.