Background
: A reasonable weight reduction method is to reduce fat-body mass while preserving fat-free mass. Recently, many people in Korea have been trying reckless diet therapy for weight reduction by means of low calory and protein diets, which gave rise to many side effects consequently. For reasonable weight reduction, this study was undertaken to investigate the significant dietary factors that change body composition during short-term low calory diet.

Methods : Twenty six healthy obese women aged 23∼37 years, whose BMI was greater than 24, volunteered for the 6 week diet therapy from January to April in 2003. All subjects were instructed to eat approximately 1,200 kcal/day and keep a dietary diary. In the beginning the 3rd week and the 6th week of the study, subjects' body weight were measured and fat body weight were measured by BIA. In the 6th week, the analysis of the dietary diary was conducted.

Results : There was a significant positive correlation between the protein intake per ideal body weight in the first 3 weeks and the fat-free mass increase in the latter 3 weeks (P＜0.05). At the same time, the fat intake in the first 3 weeks had positive correlation with the fat-free mass in the latter 3 weeks, also (P＜0.05). But, we could not find any significant values that had effect on the fat-free mass increase in multiple regression analysis.

Conclusion : The protein intake in the first 3 weeks helped to preserve the fat-free mass in the latter 3 weeks, and had positive effects.

Background
: Arterial stiffness is a strong indicator of cardiovascular risk. Increased visceral fat confers greater risks of metabolic syndrome and cardiovascular events. The aim of this study was to elucidate the relationships between arterial stiffness and regional distribution of abdominal adiposity (i.e. subcutaneous and visceral adipose tissue).

Methods : Thirty obese participants (M：F=17：13, mean age=53.6±12.0 years) underwent anthropometric measurements, laboratory procedures such as serum lipid levels and abdominal computed tomography scan. The aortofemoral pulse wave velocity was measured by foot to foot method using two continuous Doppler waves.

Results : Pulse wave velocity was positively associated with age, hip circumference (P＜0.01), visceral to subcutaneous abdominal fat ratio and body weight (P＜0.05), but independent of the total abdominal, visceral, and subcutanous fat. Although not positively associated, the mean pulse wave velocity tended to be higher in patients with history of hypertension or diabetes.

Conclusion : The site of abdominal fat distribution contribute to the prediction of arterial stiffness and visceral adiposity is associated with increased risk of cardiovascular events.

Background
: Increased WBC counts have been associated with different components of metabolic syndrome (MS), accompanied by clustering of a number of risk factors for CHD. Because most individuals have one or more of the risk factors for CHD or a cluster of MS symptoms, it may not be appropriate to look only at isolated components. Therefore, the aim of the present study was to examine the association of WBC counts with clustered features of MS in Korean adults.

Methods : The subject of this study included 593 adults (males 344, females 249) aged 20 years or older. Among the subjects, we excluded those who did not have records of physical parameters and blood test results and those who did not complete the questionnaire. We also excluded acutely ill patients. Logistic regression analyses were used to evaluate the association between WBC counts and features of the MS, with an adjustment for age, smoking and alcohol consumption.

Results : The relative risks for obesity, hypertension, hypercholesterolemia, low HDL cholesterol levels, hypertriglyceridemia, high fasting plasma glucose levels and hyperuricemia compared with WBC counts ＜5.2~10³ cells/μl, increased as WBC counts increased. The relative risks for the presence of ≥1, ≥2, ≥3, ≥4 features of the MS also increased as WBC counts increased.

Conclusion : An increased, albeit normal, WBC counts associates with the cluster of MS of the so-called "insulin resistance syndrome" and suggest that an increased WBC counts may be yet another feature of this syndrome.

Background
: Dyspepsia is a common symptom and bacause functional dyspepsia is a heterogeneous disorder its pathophysiology is not well established. We need to conceptualize in a so called "biopsychosocial model". Many Koreans tend to consider the importance of dietary habits in causes and treatment of diseases and actually many physicians recommend dietary modification for patients of functional dyspepsia. Therefore, the aim of the present study was to determine if dietary habits was associated with functional dyspepsia.

Methods : Functional dyspepsia was defined and classified by Rome II criteria. This study was performed by case and control method at the outpatient department of family medicine of six university hospitals in Seoul. Self-administered questionnaire for the demographic characteristics and dietary habits were performed in 472 functional dyspeptic patients and 236 normal controls.

Results : Only the economic status among the demographic factors was associated with functional dyspepsia and on the dietary factors. The functional dyspeptic patients reported less than 2 days regular eating for one week (OR=2.01, P=0.019, 95% CI: 1.12∼3.60) and more than 3 days overeating for one week (OR= 2.01, P=0.020, 95% CI: 1.12∼3.63), but no significant difference was found in the daily eating frequency, meal duration, frequency of spicy food comsumption, and breakfast.

Conclusion : Functional dyspepsia was associated with irregular eating patterns and overeating behavior for one week. To prevent functional dyspepsia behavioral modification such as eating regularly and avoiding overeating should be advised.

Background
: Recently, the incidence of cardiovascular diseases has increased in Korea. Hypercho-lesterolemia is a major risk factor for cardiovascular diseases. Atorvastatin (Lipitor^±) is prescribed for the treatment of hyperlipidemia in Korea, but its effect has not been studied. Therefore, we investigated the lipid lowering effect of atorvastatin in Koreans.

Methods : This study included 82 hypercholesterolemic patients who visited the Department of Family Practice of Ajou University Hospital from January 1, 2000 to December 31, 2001. The mean age of the subjects was 47.8 years in the range of 27 to 66 years. Our study included 41 controls and 41 subjects who were administered atorvastatin 20 mg daily for 3 months. Fasting serum lipid levels were measured at baseline and at 3 months. Specific dietary and exercise interventions were not instructed.

Results : At 3 months, the serum total cholesterol and LDL were significantly lower in atorvastatin group than in the control group (Total cholesterol; -5.5±16.7%, vs 25.5±15.8%, P＜0.05, LDL cholesterol; 1.4±28.5%, vs -30.1±28.9%, P＜0.05). The serum triglyceride in atorvastain group showed no significant difference relative to the controls (Control: -5.8±34.2%, Atorvastatin: -3.5±54.8%, P=0.81). But, Serum triglyceride level decreased by -14.3±33.2% in the control and -39.0±23.2% in the atorvastatin group among the patients whose baseline triglyceride level was over 200 mg/dl (P＜0.05). There was no significant differences in HDL-cholesterol (Control: 3.0±22.6%, Atorvastatin: -0.9±18.8%, P=0.38). The effect of atorvastatin was not influenced by age, sex, BMI and other risk factors.

Conclusion : Atorvastatin lowered significantly the serum total cholesterol, LDL and triglycerides in Korea. Regardless of age, sex, BMI, but had no effect on HDL level.

Background
: This study was conducted to find out the relationship between autonomous function and fatigue rating. The subjects were patients with complaints of fatigue who visited the department of family medicine in a general hospital.

Methods : We conducted this study from April to December 2002 in patients complaining of fatigue. The subjects were categorized into low, intermediate, and high fatigue groups. Heart rate variability was measured for five minutes at rest, followed by a five minute mental arithmetic test. We analyzed the relationship between fatigue ratings and autonomous function with SPSS 10.0.

Results : There was a statistically significant increase in the mean heart rate variability in the all three groups at rest and with stress. There was a statistically significant increase in LF norm increase in the low and high fatigue groups. HF norm showed a statistically significant decrease in the intermediate and high fatigue group. The variation in LF norms was highest in the low fatigue group and lowest. With the mental arithmetic test, the low fatigue group showed decreased rMSSD, HF and HF norm values compared to the intermediate group. The above values showed decrease in the high fatigue group compared to the low group.

Conclusion : Overactivity of the sympathetic nervous system was observed as fatigue ratings increased. The cadiovascular autonomic response tended to decrease as fatigue ratings increased.

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.