Background
: Prolongation of the QTc interval is a risk factor for ventricular tachycardia, ventricular fibrillation, especially torsades de pointes, and sudden death. It is associated with increasing age, female sex, some of antiarrhythmic drugs, tricyclic antidepressants, and conditions such as hypokalemia, hypothermia, subarachnoid hemorrhage, congenital long QT syndrome. Earlier studies reported lengthening of the QTc interval with increasing body mass index (BMI) and intra-abdominal fat. But no such reports exist in Korea. Therefore, we determined the relationship between BMI and the QTc interval.

Methods : The study population consisted of 372 persons who undertook periodic health examination in a university hospital between September and December 1998. BMI and standard 12-lead electrocardiogram were measured in all subjects. Excluding 4 patients who ha arrhythmia where QTc interval could not be calculated, the QT interval was measured in the electrocardiogram of 368 subjects. The QT interval was measured in the leads that showed the longest interval for three consecutive beats and then were averaged. Correlation between the calculated QTc interval and BMI was examined. The QTc interval difference according to sex and obesity was also analyzed.

Results : Among 368 subjects, there were 197 men (54%) and 171 women (46%). The mean ages were 44.5 years for men and 47.6 for women, The BMI was 23.8±3.13 (mean±SD). Obese subjects with BMI above 27kg/m² totalled 61 917%), including 31 men and 30 women, The QTc interval was 399±25 msec (mean±SD), and the subjects showed prolonged QTc intervals of 24 (12 men and 12 women). There was a statistically significant correlation between BMI and QTc interval (r=0.135, P=0.0094), and the obese subjects were found to have a longer QTc interval than the nonobese controls. Women also had a longer QTc interval than men.

Conclusion : There was a significant correlation between BMI and QTc interval, and longer QTc interval was observed in obese patients. The QTc interval should be considered when analyzing electrocardiogram of obese patients.

Background
: The risk of overweight and obesity to health is well know. Physical activity is important in the treatment of obesity in terms of healthy body composition and maintenance of body function. This study is a follow-up study to identify the impact of changes of leisure time physical activities on body weight.

Methods : The study subjects were people who visited a health examination center in Seoul at least twice between 1995 and 2000. Seven hundred people who completed physical activity questionnaires each time they visited were included. Three hundred eighty two of them were men, and 318 were women. The questionnaire was Baecke physical activity questionnaire, consisted of items for work activities, sports activities, and non-sports leisure activities. Each index of activities was calculated.

Results : Ninety seven people (13.9%) reduced their weights more than 5% of initial body weights. Twenty eight people (4.0%) gained their weights more than 5% of initial body weights. In five hundred and seventy five people (82.1%) their body weights were changed within 5% of initial body weights. Non-sports leisure time indices increased greatly and were significantly more than sports indices in reduced weight group. Non-sports leisure time indices were not changed significantly in gained weight group. The dose-response relationship existed between changed body weight (kg) and difference of leisure time indices. The multivariate analysis showed that female was a significant factor related to reducing weight (odds ratio=4.5, 95% confidence interval 2.7~7.5). Increase of non-sports leisure indices showed borderline significance (odds ratio=1.4, 95% confidence interval 0.9~2.0).

Conclusion : To increase non-sports leisure activities for the purpose of reducing body weight is actively recommendable. Such activities performed on a daily basis may have impact on reducing weight through repeatability and ease of access.

Background
: The risk of hypertension increases as body weight is gained. In most studies, smoking has been considered as a confounder in association, but such association had not been analyzed between weight and the risk of hypertension varied according to smoking status.

Methods : The subject were 1,813 male worker who had routine bealth examination from April to June in 1998. They were divided into current smokers and non smokers according to smoking status and categorized into three different weight group; normal weight (BMI<23kg/m²), overweight(23≤BMI≤25 kg/m²) and obesity(BM≥25 kg/m²). Hypertension was defined if systolic blood pressure was ≥ 140 mmHg, or diastolic blood pressure was ≥ 90 mmHg. The interaction between smoking status and BMI for prevalence of hypertension, and the prevalence odds rations for hypertension among six groups categorized according to weight and smoking status, were analyzed by multiple logistic regression.

Results : The interaction between smoking status and BMI was significant (B=-0.058, SE=0.025, P=0.021). The risk of hypertension was 1.55 times (95% C.I 0.76~3.15) higher among the non-smokers with overweight and 2.90 times (95%) C.I. 1.01~4.32) higher among the non-smokers with obesity compared to the non-smokers with normal weight after controlling for age, serum glucose, and total cholesterol. In contrast, weight was not associated with the risk of hypertension among smokers.

Conclusion : The risk of hypertension rose as the weight of non-smokers increased. However, there was no association between the weight and the risk of hypertension among current smokers.

Background
: Herpes zoster is a significant and troublesome disease. The pain of acute herpes zoster may be severs, but is usually transitory. Some patients, especially the elderly at particular risk, go on to develop neuralgia. Unfortunately, neuralgia is often severe and refractory to most forms of treatment. The purpose of this study was to estimate improved rates of neuralgia according to associated factors.

Methods : We observed the improved rates of neuralgia in 123 patients who had herpes zoster with severe pain and treated with antiviral therapy after admission. Also, we compared them by age group, dermatomal distribution, and initiating day of antiviral therapy.

Results : At 4 weeks of treatment, the improved rates of neuralgia according to age younger group was high and older group was low. the improved rates of neuralgia according to the starting day of treatment was high 100% in 1 day, 76.5% in 2, 65.0% in 3days, and 18.2% in 7 days after skin eruption.

Conclusion : In herpes zoster with severe pain, age and initiation of antiviral therapy are significant predictors of neuralgia.

Background
: Symptoms of musculoskeletal system is a common problem, followed by those of respiratory system. Most patients with problems of musculoskeletal system are examined and treated by a primary doctor. This research was performed to inquire into a method which can increase the effectiveness and the precision of history taking in patients with problems of musculoskeletal system in primary care and also to assess a self-marking method were patients can mark their pain site on a normalized picture.

Methods : In the department of family medicine and rehabilitation of an university hospital in Seoul, 44 patients with musculoskeletal pain on their first visit in an outpatient clinic were asked to put marks on a normalized picture and also mark the degree of pain with a visual analog scale from 0 to 10, before history taking. After history taking, the doctor also marked the spot of the patient's pain on the normalized picture and then compared the spots together. After comparing the two pictures of the doctor's and the patients', they then drew another picture with only one spot to avoid overlapping spots. We compared the differences among the patients in every decade from ages 20 to 60 and divided the value of visual analog scale into 3 groups concerning the spots drawn by patients, and compared the relations between them.

Results : The pain spots drawn by doctor only were on the lumbar spine and the shoulder whereas most of pain spots drawn by patients only were on the upper back, the cervical spine, and the lumbar spin. The older the patient and the lower the degree of pain was, the more humerous it had spots.

Conclusion : It is considered that with a general history taking method and a self-marking method, clinical effectiveness will be great to the patients having pain on the abdomen, the cervical spine, and the lumbar spine and to those who are elderly and with lower pain spots.

Background
: L-theanine is one of the most popular amino acids in green tea and has been known to produce mental relaxation, lower blood pressure and improve learning ability in human beings. But, few studies on these effects for human beings have been conducted so far. This study was conducted to evaluate the effect of L-theanine containing functional beverage on mental relaxation and fatigue perception.

Methods : Twenty healthy volunteers aged 30 to 55 years those who has had persistent fatigue for more than 1 month without any specific disease were recruited through written advertisement. All the subjects gave their informed consent, and the study was approved by Institutional Review Board of St. Mary's Hospital. This study was performed in a randomized placebo controlled double blind cross over fashion. Pathologic fatigue due to disease state was screened through medical history, physical examination, laboratory tests and questionnaires. a to B power value of EEG as a surrogate marker of mental relaxation was measured in frontal and occipital regions for an hour after administration of placebo or test (200 mg L-theanine)solutions and crossed over at 7-day intervals. We analyzed a to B power value of EEG in frontal and occipital regions at 10 minute intervals for each 5 minutes. The baseline and 7-day follow-up scores of fatigue severity scale (FSS) were also evaluated.

Results : Repeated ANOVA revealed that there were significant differences of frontal a to B power value between placebo and test in high anxiety group (P<0.01). The mean values at 15, 25, 35, 45, and 55 minute intervals were 0.57, 0.48, 0.52, 0.66, and 0.61 in placebo, respectively, and 0.73, 0.82, 0.78, 0.91, and 0.97 in test, respectively. But there were no significant differences of frontal a to B power value between placebo and test groups with low anxiety (P>0.05). Fatigue score was significantly decreased in test (P<0.05), but not in placebo (P<0.05) after 7-day administration of placebo or test solutions. The mean differences from baseline in placebo and test were -0.42, and -0.80, respectively.

Conclusion : The results of this study suggest that L-theanine containing functional beverage should promote a to B power value in relation to mental relaxation, and also have the effect of reducing the fatigue perception.

Background
: Lymphedema is a common condition occurring in over 50% of breast and cervix cancer patients. The pneumatic pump as used in the past is still utilized for the treatment. A complex lymphatic therapy was developed by Dr. Michael Foeldi of Germany in the 1980s, and was widely practiced with good effects. This study was to observe the practical effectiveness in patients receiving such treatment.

Methods : Twenty two patients diagnosed with lymphedema and treated in department of Family Medicine of National Health Insurance Corporation Ilsan Hospital from August 1,2000 to September 30, 2001. They were observed with respect to the frequency of demographic characteristics, and were compared to assess the improvement of clinical symptoms before and after complex lymphatic therapy by independent samples T-test and the degree of edema reduction before and after complex lymphatic therapy by paired samples T-test (P-value<0.05).

Results : Among the 22 subjects I was a male and 21 were females and their mean age was 49.9±9.3. Cervix and breast cancer patients comprised 86.4% among the total. Twenty one cancer patients developed lymphedema after the operation or radiotherapy. Most were in stage 2 or 3 of edema with 81.8%. Relative to the edema onset time, there were 7(33.3%) of less than 1 year, 5(23.8%) from 1 to 3 years and 9 (42.9%) over 3 years. They came to see a lymphedema specialist in 2.9±3.9 years after edema progressed. The degree of lymphedema with 968.4±545.3 ml before the treatment was improved to 337.3±326.8 ml after the of lymphedema with 968.4±545.3 ml before the treatment was improved to 337.3±326.8 ml after the treatment which showed a statistically remarkable 65.0±33.2% effectiveness.

Conclusion : complex lymphatic therapy for the patients of lymphedema presented with a 65% edema reduction in our study. Thus, the therapy for such patients is considered the most effective method up to present.