Background
Bioelectrical impedance analysis (BIA) is frequently used to diagnose obesity in clinical setting, but the usefulness of BIA in children is not become known accurately. We analyzed the usefulness of BIA and anthropometric measurement compared with Dual-energy X-ray absorptiometry (DXA) as a diagnostic tool of childhood obesity. Methods: 205 volunteer primary and middle school children were recruited. We measured weight and height, and analyzed the body composition by BIA and DXA. By paired t-test and Bland-Altman plots, mean difference and limit of agreement were calculated between DXA and BIA according to sex and age groups. Sensitivity and specificity were displayed with the gold standard of PBF above 35% by DXA. Results: There was significantly positive correlation between DXA and BIA in fat mass (FM) (r=0.982, P＜0.001), fat free mass (FFM) (r=0.990, P＜0.001), and percent body fat (PBF) (r=0.956, P＜0.001). Mean difference between DXA and BIA in FM, FFM, and PBF were ⁣0.4⁑1.4 kg (P＜0.001), ⁣0.6⁑1.3 kg (P＜0.001), and 0.5⁑2.8% (P=0.016), respectively. Limit of agreement in FM, FFM, and PBF were ⁣0.4⁑2.7 kg, ⁣0.6⁑2.5 kg, and 0.5⁑5.5%, respectively. The most sensitive method of diagnosis of obesity was Korean BMI standards for 85 percentile (94.7%) and IOTF BMI 25 kg/m² (94.7%). The sensitivity and specificity by BIA were 90.7% and 97.7%. Conclusions: BIA was not interchangeable with DXA. However because of higher diagnostic accuracy and correlation, it could be used to measure body composition as simple field method. We recommend Korean BMI standards for 85 percentile or IOTF BMI 25 kg/m² as the screening test for diagnosis of Korean childhood obesity. (J Korean Acad Fam Med 2007;28:523-531)

Background
: InBody 4.0, a bioelectrical impedance analyser (BIA) has an automatic function of printing out the measurement data of visceral fat area. The purpose of this study was to assess the usefulness of the visceral obesity measured by the InBody 4.0 and the waist circumference

Methods : A total of 124 participants who visited an obesity clinic in a university hospital were measured their waist circumference, height, weight and the visceral fat area by the InBody 4.0 and CT scan. The mean difference and agreement between the two visceral fat areas by the two methods had been analyzed according to sex, age and BMI groups. The accuracy of the visceral obesity by the BIA and the waist circumference was respectively compared with the visceral obesity by the CT scan.

Results : There was no significant difference between visceral fat area measured by the CT and the BIA in women participants under 46 years of age and below BMI 30. When comparing visceral fat area obtained from the CT with those obtained from the BIA, the 95% confidence interval for the limit agreement was higher in male subjects than in females. The waist circumference was the more sensitive method to diagnose visceral obesity than the BIA (91.80% vs. 77.94%), but the BIA method showed a higher specificity than the waist circumference (76.79% vs 52.38%).

Conclusion : Waist circumference turned out to be more useful than the BIA as a screening tool for visceral obesity. In the group of males, BMI of over 30, or the age over 46 years, it is recommended that the CT rather than the BIA for measurement of visceral fat area be utiliged.

Background
: Although family physicians are performing an increasing number of esophagogastoduodenoscopies(EGDs), there is little research conducted in Korea. Thus, the purpose of this research is to assess the ability of family physicians in performing EGD.

Methods : All EGDs performed by family physicians in the department of family medicine of one general hospital from January 1995 to December 1996 were reviewed retrospectively through medical records. The including physicians a family physician and nine family residents, performed EGDs five times per week.

Results : 4,468 EGDs were performed on 4,313 persons during the two years. No major complications were noted and all of the procedures were completely investigated to the second portion of the duodenum. Normal findings were 1,268 cases(28.4%) and abnormal findings were 3,200 cases(71.6%). Among the abnormal findings, gastritis was the most common finding(73.7%). The most common pathologic diagnosis was peptic ulcer 37.7%(177/470cases). Positive rate of CLO test was 89.4%. Family physicians, endoscopic diagnosis agreed with pathologic reports in 86.6%. The number of EGDs performed by each family physician ranged from 2 to 1,503 cases. Data of six physicians who performed more than 200 EGDs for their diagnostic were comparatively analyzed ability. Diagnosis of normal, gastritis or gastric ulcer was significantly different(P<0.05) according to each physicians but the diagnosis of duodenal ulcer was not statistically different(P<0.05). There was little difference among physicians in the biopsy rate. The agreement ratio between endoscopic diagnoses and pathologic reports among those physicians who performed more than 200 procedures were 79.7-93.3% and were not statistically different(P<0.05).

Conclusion : This study is the first report of EGDs performed by family physician in Korea. Some family physicians performed more than 4,000 EGDs without major complications in primary care. These data confirm the ability of some family physicians to perform EGD. Biopsy analysis indicates the diagnostic accuracy is high. Further study on performance of EGD by family physicians and its standardization concerning description of endoscopic are needed.( J Korean Acad Fam Med 1999;20:1027-1039)