Obesity is an independent risk factor for cardiovascular disease, hypertension, and diabetes and is associated with several other medical and psychological disorders. Weight loss is known to reduce these risks and to improve or resolve these cormorbid disorders and it is generally assumed that weight loss will improve the health of large people. But there is little research to support this. And no randomized controlled trials have been published to demonstrate that intentional weight loss in the obese actually reduces morbidity or increases longevity. In fact, the large majority of published epidemiological studies show that persons who experience a net loss of weight over time have shorter life spans than those whose body weights remain relatively stable. In addition, many persons who have intentionally lost weight report that they ultimately gain back some or all of the weight they originally lost. For some persons, this pattern of weight loss followed by regain will be repeated over many years of dieting and be exposed to the risk for eating disorders. These findings suggest that our current attitude or assume about weight loss should be challenged or reevaluated. With a culturally determined esthetical ideal and well-documented salutary effects of intentional weight loss on physiological risk factors, dichotomous thinking pattern about weight loss that weight loss is good one but weight gain even weight maintenance above normal is bad one has been prevailing. Therefore, intentional weight loss has been prevalent and intentional weight loss and it's related physical and psychosocial problems may become one of the most common health related issue in Korea. However, the efforts for weight control have been mainly focused on the weight loss rather than weight maintenance without serious consideration about long-term consequences of weight loss. To provide more balanced informations for weight loss and weight control, the authors reviewed the literatures concerning physical and psychosocial effects of weight loss, and effects of weight loss on morbidity and mortality. And we also reviewed the literatures about possible problems that may be resulted by various methods of weight control and discussed what is more appropriate approaches to the weight control.

Background
: In this study we estimated the prevalence of cardiovascular (CV) risk factors according to waist-to- height ratio (W/Ht ratio) in adult obese women to ensure the importance of abdominal obesity and determined the usefulness of W/Ht ratio as a index of abdominal obesity in adult obese women.

Methods : The study subjects were 190 adult obese women who visited an obesity clinic from August, 2001 to January, 2003. They were divided into 4 groups: Group 1; BMI＜30, W/Ht＜0.6, Group 2; BMI＜30, W/Ht≥0.6, Group 3; BMI≥30, W/Ht＜0.6, and Group 4; BMI≥30, W/Ht≥0.6. In each group, we compared the prevalence and odds ratio for CV risk factors.

Results : In obese group, the prevalence of high blood glucose (P＜0.01), hypertriglyceridemia (P＜0.01) were significantly higher in group 2 than group 1. In high obese group, the prevalence of systolic hypertension (P＜0.01), high blood glucose (P＜0.01), hypercholesterolemia (P＜0.01), hypertriglyceridemia (P＜0.05), and high LDL-cholesterol were significantly higher in group 4 than group 3. When odds ratio for each group with reference to group 1 were compared after adjusting for age, high blood glucose (4.48), and hypertriglyceridemia (6.10) in group 2, and systolic hypertension (2.69), high blood glucose (3.02), and hypertriglyceridemia (4.00) in group 4 were significantly higher.

Conclusion : The prevalence of CV risk factors were likely to be increased in higher W/Ht group independently to BMI. W/Ht ratio can be a simple, useful index for abdominal obesity and its related risk factors not only in adult males but also in adult obese women.

Background
: The aim of this study was to elucidate the relationship between nonalcoholic fatty liver disease diagnosed by ultrasonography and the metabolic syndrome defined by NCEP-ATP III criteria.

Methods : Sixty-nine adult male subjects with negligible alcohol consumption underwent an anthropometric and laboratory investigation. The ultrasound scan of the liver was performed to determine the presence and the severity of nonalcoholic fatty liver disease.

Results : Nonalcoholic fatty liver disease was diagnosed in 36 cases by ultrasound scan. According to the severity of nonalcoholic fatty liver, triglyceride, HDL- cholesterol, alanine aminotransferase, aspartate aminotrasnferase, fasting insulin level, HOMA-IR, and obesity related variables (body mass index, percent body fat, waist circumference) showed a significant difference. The independent variables which account for the severity of nonalcoholic fatty liver disease was waist circumference, and alanine aminotransferase which is a predictor of nonalcoholic steatohepatitis. The prevalence of metabolic syndrome was 41% vs 6.1% in nonalcoholic fatty liver group vs control group, respectively, and the odds ratio was 11.1 (95% CI 2.29∼53.6). The prevalence of nonalcoholic fatty liver was increased with increasing the number of features of metabolic syndrome.

Conclusion : Nonalcoholic fatty liver disease was closely related to the metabolic syndrome and the severity classification of nonalcoholic fatty liver by ultrasound scan could be useful to predict of the severity of insulin resistance, and the risk of nonalcoholic steatohepatitis.

Background
: Platelet activation has been implicated in the pathogenesis of a number of diseases, which include atherosclerosis, coronary vascular disease, and cerebrovascular disease. There have been controversies with the influence of hormone therapy on platelet activation. The purpose of this study was to define the effect of long-term hormone therapy on platelet activation.

Methods : We recruited a total of 162 postmenopausal women aged 55 and above among wihch eighty healthy postmenopausal women had received hormone therapy for more than 5 years and the remaining eighty- two healthy postmenopausal women with no hormone therapyapy. Baseline characteristics as well as the parameters related to platelet activation were compared between the two groups using T-test. After platelet activation was defined by the reference range, multivariated logistic regression analysis was performed determining the odds ratio of hormone therapy on platelet activation.

Results : The MPC and PCDW were significantly lower in the HT group than the Non-HT group (P＜0.001), which suggests that platelets were more activated in the HT group more than in the non-HT group. Multiple logistic regression analysis showed that the odds ratio of the possibility of platelet activation in HT group was 19 times (P＜0.001).

Conclusion : Long term hormone therapy increased platelet activation significantly, which may be a contributing factor of thromboembolism.

Hypereosinophilic syndrome is a rare disease characterized by marked peripheral eosinophilia and eosinophilic infiltration of many organs such as heart, lung, central nervous system, liver and spleen. This disease is defined by following criteria. First, sustained blood eosinophilia is greater than 1,500/mm³ longer than 6 months. Second, other apparent etiologies for eosinophilia must be absent, including parasitic infestation and allergic disease. Third, patients must have signs and symptoms of organ involvement. In Korea, some cases that eosinophil infiltrated lung, liver, gastrointestinal tract or skin were reported. In this report, we found a case showing myalgia, fatigue and eosinophilia in periodic health examination, and diagnosed hypereosinophilic syndrome.