Background
According to previous epidemiologic studies, the metabolic syndrome, dietary and lifestyle factors were associated with colon polyps. The aim of this cross-sectional study was to assess the relationship between the risk of the colorectal adenoma incidence and the individual components of the metabolic syndrome with lifestyle factors such as drinking, cigarette smoking and physical activity. Methods: Sigmoidoscopic examination for colon cancer screening was performed from January 2002 to December 2003 at the Health Promotion Center of Ulsan University Hospital in Ulsan, Korea. A total of 1,565 subjects underwent satisfactory sigmoidoscopy. The subjects with a history of colon cancer or polyps or inflammatory bowel disease were excluded from the study. Alcohol consumption, cigarette smoking and other confounding factors were included as covariates in the models. Results: After adjusting for age, physical activity, smoking and alcohol intake, the subjects of metabolic syndrome (≥3 vs. 0 components) combined with cigarette smoking had a positive association with colorectal adenoma incidence (OR 3.63, 95% CI 1.49∼8.89). Physical activity was negatively associated the risk of the colorectal adenoma incidence (OR 0.60 95% CI 0.44∼0.81). Conclusion: These results suggest that clustering of components of the metabolic syndrome combined with cigarette smoking significantly increased the colorectal adenoma risk, but physical activity reduced the risk of colorectal adenoma incidence in Korean adult males after multivariate adjustment. (J Korean Acad Fam Med 2008; 29:195-200)

Background
The relationship of lifestyle and socioeconomic factors with weight change over 4 years in Korean middle-aged group was assessed. Methods: A total of 1,167 men, aged 40∼59 years, were selected from the Health Promotion Center of Ulsan University Hospital during the period of Jan. 2000 through Mar. 2000. Including anthropometric measures, designed questionnaires were administered concern lifestyle behavior topics with cigarette smoking, exercise, alcohol consumption, dairy product consumption and socioeconomic factors of monthly income and education. The subjects were divided into three groups by body mass index (BMI: kg/m²); normal (＜23 kg/m²), overweight, and obesity (≥25 kg/m²). After 4 years of follow-up, the men were classified into weight change categories; 1) stable weight group (from normal to normal, from overweight to overweight) and 2) weight gain group (from normal to overweight/obesity, from overweight to obesity). Results: The weight gain group were 18.4% (n=215) and the stable overweight group were 81.6% (n=952). Adjusted for age, the frequency of dairy product consumption, the frequency of alcohol drinking, the regularity of exercise, education and monthly income, the smokers (≥10/day) had significantly high incidence rates of increase in weight (odds ratio=1.77, 95% CI 1.07∼2.90). The increased dairy consumers (≥4/week) had significantly low incidence rates of increase in weight (odds ratio=0.43, 95% CI 0.20∼0.93). Otherwise, there were no significant relationships in weight change. Conclusion: Smoking and decreased dairy product consumption were related to the increase in weight. (J Korean Acad Fam Med 2008;29:102-107)

Background
: According to previous epidemiologic studies, dietary and life style factors were associated with colon polyps. Despite the high prevalence of colon polyps, little is known about its risk factors in Korean adults. The aim of this cross-sectional study was to assess the relationship between alcohol consumption, smoking, obesity, physical activity and the presence of colorectal polyps.

Methods : Sigmoidoscopic examinations for colon cancer screening were performed from January 2002 to December 2003 at the Health Promotion Center of Ulsan University Hospital. Alcohol consumption, smoking and other confounding factors were assessed by self-administered questionnaire.

Results : After adjusting for age, physical activity, obesity, total fat and total energy intake, current smokers who had smoked more than 21 pack-years were at significantly higher risk of adenomatous polyps compared to non-smokers (OR 2.56, 95% CI 1.30∼5.01). Alcohol consumption was positively associated with risk of adenomatous polyps compared to non-drinkers (OR 1.48, 95% CI 1.03∼2.13). Physical activity was negatively associated with risk of distal colon polyps.

Conclusion : These results suggest that alcohol consumption, cigarette smoking, and obesity were positively associated with risk of colorectal polyps and physical activity was negatively associated in Korean adult males.

Background
: Electrocardiographic QTc interval prolongation can cause serious arrhythmias such as ventricular tachycardia, ventricular fibrillation, torsade de pointes, and even sudden death. Many studies have been performed to clarify whether QTc interval prolongation is related to increasing body mass index (BMI) and abdominal obesity. However, there is no study about the relationship between abdominal obesity and QTc interval prolongation in Korea. We, therefore, studied the relationship between QTc interval prolongation and abdominal obesity among Korean adults.

Methods : The measurement of height, weight, and waist circumference, and standard 12-lead ECG was performed on 3,086 subjects at a health promotion center of a university hospital from March to April, 2003. We excluded: 37 subjects whose ECG or body measurement was not performed, 17 with a past history of cardiac disease or current cardiac medications which can influence QTc interval, 9 taking neuropsychiatric medications, 25 with abnormal serum concentration of potassium or calcium, 1 foreigner and 59 with underweight. First, we studied the correlation between BMI and waist circumference. Then, we analyzed the relationship between QTc interval prolongation and the index of obesity.

Results : A total of 2,938 subjects consisted of 2,411 men and 527 women. BMI and waist circumference were shown to have a significant correlation with QTc interval after age was adjusted in men (P＜0.01, P＜0.01). The odds ratio between QTc interval prolongation and the subjects of normal, overweight, and obesity by BMI were not significant in both men and women. In men with abdominal obesity, the odds ratio between QTc interval prolongation and abdominal obesity by waist circumference was 1.33 (0.99∼1.79).

Conclusion : In men, abdominal obesity was shown a positive correlation with QTc interval prolongation. But these results were not statistically significant.

Background
: The results of previous epidemiologic studies showed that dietary and life style factors are associated with colon polyps. Despite the high prevalence of colon polyps, little is known about its risk factors in Korean adults. The aim of this study was to assess the relationship between physical activity and the presence of colorectal polyps.

Methods : In 859 subjects, rectosigmoidoscopy was performed at Ulsan University Hospital Health Promotion Center from January 2002 to October 2002. Drinking, smoking and other confounding factors were assessed by self-administered questionnaire in 161 subjects with colon polyps and 698 controls.

Results : Among the total of 859 cases the prevalence of colorectal adenomatous polyps was 18.7%. After adjusting for age, sex, physical activity, obesity, calcium and total energy intake, using multiple logistic regression, decreasing risk of colorectal polyps were observed with increasing level of physical activities. The odds ratio for 3 to 4 hours per week exercise group was 0.460 (CI=0.262∼0.809). The frequency and intensity of exercise also had an inverse association with colon polyps (4∼5 times/ week group: OR=0.428, CI=0.220∼0.832; vigorous exercise group: OR=0.454, CI=0.298∼0.693).

Conclusion : Physical activities were inversely associated with colorectal polyps in Korean adults.

Background
: This study was done to examine the relationship between distorted self-perception of body weight and some sociodemographic factors in Korean adults.

Methods : This study was conducted among 14,621 adults (men 10,833, women 3,788), who visited Ulsan University Hospital Health Promotion Center to take a routine health examination. The objective body weight status was classified as underweight, normal, overweight, and obesity by body mass index. We compared the self- perception of body weight with in objective body weight status. We used multiple logistic regression to assess the odds ratio for distorted self-perception of body weight by age, marital status, monthly income, and level of education.

Results : Among the total 72.8% of obese men had a distorted self-perception of being slightly excess, 48% of overweight men considered themselves as just about right, and 39.5% of men with normal body weight as underweight. In women, 36.5% with normal body weight had a distorted self-perception of being slightly excess or very excess. In both men and women who were overweight or obesity, the distorted self-perception of being just about right was increased with higher age and lower education. The odds ratio of distorted self-perception in normal as being slightly excess or very excess was higher in women with higher income and higher education.

Conclusion : In both men and women, many people had a distorted self-perception of Body weight. Some sociodemographic factors were found to be related to the self- perception of body weight.

Background
: Hormone replacement therapy (HRT) has been used as a effective therapeutic strategy of postmenopausal osteoporosis. However, the studies on HRT are insufficient, particularly in early postmenopausal women in Korea. This study was designed as a community based clinical trial and was conducted for 1 year.

Methods : One hundred and forty early postmenopausal women aged 49 to 54 years who resided in Ulsan in Korea were enrolled in this study. The osteoporosis prone life style and general characteristics of the participants and their measured BMD were investigated. The therapy groups included 45 women who were assigned to one of the following regimens in 28 day cycles for 1 year: (1) conjugate equine estrogen (CEE), 0.625 mg/d daily, medroxyprogesterone acetate (MPA) 2.5 mg/d daily and calcium 500 mg/d daily (2) CEE 0.625 mg/d daily, MPA 10 mg/d for days 1 through 12 and calcium 500 mg/d daily.

Results : The women in the therapy groups had an average gain of 5.4%, 4.2%, 2.1%, 4.9% in BMD in the lumbar spine, femur total, femur neck and ward's area, respectively. HRT has significantly influenced the BMD after controlling age, month since menopause, alcohol intake, smoking, calcium intake, exercise, body mass index and baseline BMD. The baseline BMD and the BMI were factors that influenced the effect of HRT in BMD.

Conclusion : HRT had positively influenced the BMD in Korean women. The baseline BMD and the BMI were predictors of the effect of HRT in BMD change.

Background
: The decisive factors influencing the eradication of H.pylori still remain unclear. It was our aim to assess H.pylori eradication rte with proton pump inhibitor based triple therapy and investigate the clinical characteristics and endoscopic factors.

Methods : We investigated 106 male patients with H.pylori-positive peptic ulcer. The patients were treated with a 1-week regimen composed of omeprazole, amoxicillin and clarithromycin. The success of the treatment was evaluated by histology at least 4 weeks after completion of therapy. Endoscopic factor and clinical factors influencing H.pylori eradication were assessed.

Results : The overall eradication of H.pylori was successful in 87 of 106 patients (82%). The eradication rate was higher in those who drink or smoke, with gastric ulcer, less than 50 years old but these factors did not significantly influence the outcome of treatment.

Conclusion : H.pylori eradication rate with omeprazole, amoxicillin, and clarithromycin did not differ from other studies. These results suggest that factors such as smoking, drinking, age and ulcer site did not influence the eradication rate of H.pylori.

Background
: Sigmoidoscopy reduce colorectal cancer mortality by identifying both cancer and adenomatous polyp for treatment. However, this screening technique, sigmoidoscopy is extremely limited to family physician. We performed sigmoidoscopy and attemped to analyze colon polyps.

Methods : The authors performed rectosigmoidoscopy from January 2000 to January 2001 at ulsan university hospital health promotion center. We reviewed and analyzed all subjects at which time all polyps were biopsied.

Results : In total, 1107 case sigmidoscopy examination were performed without complication. Polyps were found in 11.5%. 44.5% were neoplastic adenoma and 33.6% were hyperplastic polyps. Cancer was detected in 2 subjects. All case of neoplastic and 33.6% were hyperplastic polyps. Cancer was detected in 2 subjects. All case of neoplastic polyps were refered to colonoscopist. The difference of polyp incidence rate was significant in age and sex group(p<0.01).

Conclusion : The prevalence of colon polyps was 11.5%. This data is simillar to colonoscopist's data. These results suggest that screening sigmoidoscopy can be performed usefully by family physicians.

BACKGROUND
Physical activity and calcium nutriture with reproductive endocrine status are primary controller of bone remodelling activity. There are differences in impact of exercise on early menopausal bone ; late menopausal bone. There are possibility of different effect of calcium intake on bone mass among different life stage. The aim of this study was to elucidate whether the relation between lifestyle and bone mineral density varied with life stages.
METHODS
We examined bone mineral density and took questionnaires related to lifestyle of 1,698 women aged 49~54 years old who lived in ulsan from July 1999 to Dec. 1999. We selected 731 healthy subjects without medical conditions or lifestyle factors known to affect bone metabolism.
RESULTS
In 6~10 years postmenopausal women, those with calcium intake of more than 600 or 800mg /day showed significantly greater BMD. In postmenopausal women , those daily consumption of milk showed greater BMD. But it is not significantly. In premenopausal women with regular menstruation, those who took regular exercise showed significantly greater BMD than those who did not. Working hours is not related with BMD.
CONCLUSIONS
Our study showed that the relation between calcium intake or physical activity and BMD differed with life stages. It was suggested that life stages should be taken into consideration to perform lifestyle modifications for the prevention and management of osteoporosis.

Background
: Osteoporosis is chronic disease, therefore education about osteoporosis is very important in patients and high risk groups. The objective of this study is to assess the effect of audiovisual instruction about osteoporosis in perimenopausal women. Methods : We educated perimepopausal women who lived in Ulsan about lifestyle behavior related to osteoporosis from July.1999 to Dec.1999 and assessed improvements of lifestyle behaviors related to osteoporosis and evaluated factors that influence hormone replacement therapy uptake. Results : After the audiovisual instruction, hormone replacement therapy uptake, milk intake and exercise were significantly increased in only experimental group. But, smoking and coffee intake were not significantly decreased in both control group and experimental group. After the audiovisual instruction, the factor that significantly influenced hormone replacement therapy uptake was type of education and osteoporosis of participants and also it were significant after adjustment of multiple comparison. Menopause of participants influenced hormone replacement therapy but it was not significant after adjustment. Conclusion : Our study suggests that community intervention trial against osteoporosis improves lifestyle behaviors in perimenopausal women. Longer term studies are needed to determine the relationship between improvements in lifestyle behaviors and osteoporosis.

Background
: Liver disease is an important public health problem in Korean. The aim of this study was to estimate the prevalence of hepatitis C virus antibody(anti-HCV) in the adult population of Ulsan and to identify risk factors for HCV infection by case-control study.

Methods : The anti-HCV test was performed in 10,140 adults older than 20 years of age who underwent a general medical checkup in Ulsan University Hospital, Health Promotion Center from January 1997 to November 1997. 33 cases and 99 controls matched for age and sex with a 1:3 ratio of cases to controls were enrolled. The cases were defined as positive anti-HCV and positive HCV-RNA whereas the controls were negative anti-HCV, negative HBsAg and ALT ≤40. Exposure data were obtained by self-administered questionnaire.

Conclusion : The overall prevalence of anti-HCV was 1.3% and true prevalence of HCV infection was 0.45% in the adult population of Ulsan. Transfusion was the major route of transmission of HCV but the risk will likely reduce.

Background
: The increase of smoking prevalence in adolescents is serious problem because of physical and psychological influences furthermore, fixation of smoking habit. This study is aimed at providing applicable basic information to setting up the education programs and strategies to prevent smoking among high school students by analysis smoking behavior an its related factors.

Methods : 835 students from one senior high school in Taegu completed a self administerd questionnaire during school hours in May, 1996. 813 questionnaires with adequate responses were analyzed using SPSS/PC program. All students were asked class years, school satisfaction, school performance score, number of their three best friends who smoke, smoking status of their fathers, religion, allowance, alcoholic drinks, addicting drug use, Zung's self-rating depression scale(SDS) and Zung's self-rating anxiety scale(SAS). Smokers were asked amount of smoking, motives for smoking, when they started smoking, Fagerstrom score.

Results : Of the 813 students in the sample 135(16.6%) were current smokers. About the amount of smoking, 59.3% smoked less than 5 cigarettes/day. About the motives of smoking, 34.8% started smoking through the solicitation by friends or for making friends. About when they started smoking, 52.6% started smoking before entrance into senior high school. The related factor with smoking included class years, school satisfaction, school performance score, number of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, SDS. Predictors of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance. The related factors of nicotine dependency were amount of smoking, allowance, when they started smoking. Predictor of nicotine dependency were amount of smoking, number of three best friends who smoke.

Conclusion : The related factors with smoking included class years, school satisfaction, school performance score, number of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, and SDS. Predictors of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance.