Background
: Bupropion SR (sustained-release) is the first non-nicotine-based therapy that is effective for achieving abstinence from smoking. We conducted this clinical trial of bupropion SR for smoking cessation with a seven week follow-up.

Methods : The study subjects involved fifty smokers who had visited the Family Medicine Department at Asan Medical Center from May 2003 to January 2004. Treatment consisted of seven weeks of bupropion 150 mg twice daily. The target day for quitting smoking was day 7.

Results : Among 50 subjects who had received bupropion SR, 28 subjects completed the clinical trial and were analyzed. Nineteen subjects were lost to follow up after their first visit. Three subjects discontinued the medication on their own and were lost to follow up after their second visit. According to a telephone interview, 17 subjects out of 22 subjects who were lost failed to feel the need of a revisit for smoking cessation. The rate of abstinence was 26.77% at week 7. The major causes of relapse in smoking were stressful events and anxiety. Only one subject discontinued the treatment attributed to adverse event (nausea). The most common adverse events were insomnia, anxiety, arthralgia, and nausea. We studied to see if the amount of smoking, other smokers in the household, previous attempts to quit, Beck Depression Inventory, and Fagerstrom Tolerance Questionnaire were associated with smoking cessation. However, they failed to show any significant correlation.

Conclusion : This trial showed that the abstinence rate at the end of 7th week was 25.7% without any serious adverse events.

Background
: The mechanism of fatigue in patients with fibromyalgia (FM) and CFS (CFS) has not been clarified, but recently there are opinions that chronic pain is a major factor causing chronic fatigue. We performed this study to identify major factors related to chronic fatigue.

Methods : The subjects were 37 patients aged over 18 who visited the primary care institute of a university hospital, whose major symptoms were chronic widespread pain and chronic fatigue and who were given the diagnosis of FM or CFS. The research was carried out through four weeks of symptomatic treatment. The correlation of fatigue severity with the intensity of pain, depression level and anxiety level was analyzed, and regression analysis was conducted to examine the relation between improvement of fatigue after the four weeks' treatment and changes in the intensity of pain, depression level and anxiety level.

Results : After the four week treatment, only the intensity of pain was significantly correlated with fatigue severity. In addition, only change in the intensity of pain was statistically significantly correlated with the improvement of fatigue.

Conclusion : In patients who complained of chronic fatigue and chronic widespread pain, the improvement of fatigue after treatment was related to the reduction of pain but not emotional factors such as depression and anxiety.

Background
: Gastroesophageal reflux disease (GERD) is common in Western civilization and comprises 75% of esophageal diseases. However, there are only few studies of GERD in Korea. The aim of the study was to evaluate the clinical symptoms of GERD in Koreans and the effect of Rabeprazole on the symptoms.

Methods : The study subjects were included 353 patients who were diagnosed endoscopically with reflux esophagitis (316) or non-erosive reflux disease who have complained of intermittent heartburn during the past 3 months or more. All patients received Rabeprazole 20 mg daily for 8 weeks. Symptoms according to 8 symptom categories of GERD were evaluated. Patients recorded the severity of GERD associated symptoms at baseline, 4 weeks and 8 weeks after treatment. Presenting symptoms in Korean, frequency and severity of each symptom was evaluated. Efficacy of Rabeprazole treatment was analyzed.

Results : The most common symptoms of GERD were regurgitation (60.9%), heartburn (52.7%), epigastric pain/ soreness (49.6%) and other epigastric discomfort (47.0%). Symptom severity was rated in order of epigastric pain/ soreness, epigastric discomfort, and heartburn. The proportion of all symptoms, except for heart burn and cough, increased in relation to the severity of endoscopic grading, but the severity of symptoms was not significantly different between subgroups according to endoscopic findings. Symptoms, except for hoarseness, globus sensation and cough, significantly improved in 4 weeks after treatment. Cough did not improve after 4 weeks irrespective of smoking status, All symptoms significantly improved after 8 weeks.

Conclusion : Regurgitation was more common, and epigastric symptoms were more severe than heartburn in Koreans. The 8-week Rabeprazole treatment was effective on all symptoms associated with GERD.

Background
: This study was aimed to investigate the diagnosis-related characteristics of the microvascular complications among patients with type 2 Diabetes Mellitus and to identify the relationship ship between regular check-up and detection of complications of diabetes.

Methods : The study subjects were 63 patients with diabetic microvascular complications. The data were collected with self-administered questionnaire and analyzed with descriptive statistics.

Results : The main motive to identify retinopathy was through 'visiting hospital after having symptoms (58.9%)', and not through regular checkup. The most common symptom of retinopathy was dim dye (84.3%) and the mean duration after diabetes mellitus diagnosis was 6.8 years. The main motive to identify renal complications was through 'visiting hospital after having symptoms and checking for other complications (28.0%)'. The most common symptom of renal complications was edema of face and hands (72.0%) and the mean duration following diabetes mellitus diagnosis was 8.4 years. The main motive to identify neuropathy was through 'visiting hospital after having symptoms (34.8%)', and not regular checkup. The most common symptom of neuropathy was tingling sensation of feet (100.0%) and the mean duration following diabetes mellitus diagnosis was 7.4 years.

Conclusion : Based on the results, we suggest that diabetes complications check-up should be performed simultaneously to make the diagnosis of diabetes mellitus, and that the health care providers could provide them with more opportunities to have such check-ups with standardized complications care guidelines.

Background
: Several studies have revealed a relationship between the cognitive decline and several cardiovascular diseases. The relationship between the metabolic syndrome and cognitive function has not been studied yet in Korea. The objective of our study was to determine the relationship between the metabolic syndrome and cognitive function in elders above 50 years old.

Methods : We examined subjects who visited the health promotion center of one college hospital in Seoul. The metabolic syndrome was defined according to the National Cholesterol Education Program guidelines and we categorized the two groups by the presence of the metabolic syndrome. We used the Korean version of Mini Mental State Examination to check the cognitive functions and compared scores between these two groups.

Results : There were a total of 400 subjects (195 men and 205 women). Compared with those without the metabolic syndrome, elders with the metabolic syndrome had lower mean scores in K-MMSE (26.6±2.0-28.2±1.8, P＜0.001). In subcategories of K-MMSE, the average scores of concentration or calculation were lower in the metabolic syndrome group (3.5±1.3) than in the control group (4.3±1.0) and the average scores of delayed recall were lower in those with the metabolic syndrome (1.7±0.9) than the control group (2.2±0.8) (P＜0.001). After controlling for age, sex, education, smoking, alcohol, and body mass index, multiple regression yielded the metabolic syndrome to be independent associated factor in cognitive function (P＜0.001).

Conclusion : We found a significant relationship between decreased cognitive function and the metabolic syndrome. There are needs for prospective study about the possible development of dementia in the metabolic syndrome and probable prevention of dementia when cardiovascular risk factors in those are modulated.

Background
: Childhood and adolescent obesity are major health concern impacting on short and long-term health. Prevention programs for obesity through school channel are essential. With the increasing prevalence of obesity and overweight among children and adolescence since 1990's, obesity prevention and management have been pursued in Korea. Schools, where students spend much of their daytime, are in a unique position to play a pivotal role in performing obesity prevention and management programs. The objective of this study was to assess the effectiveness of school-based interventions designed to prevent or manage obesity among elementary, middle, and high school students in Korea.

Methods : Electronic database were searched using the following key words; obesity, obesity prevention, obesity prevention program, child, adolescence, and effectiveness. In this systematic review, school-based programs were evaluated with the assessment items.

Results : Thirteen studies were included in the study. Most programs include at least one of the following components: dietary changes, physical activity, behavioral modifications, and parental participation. Studies that involved multidisciplinary measures including dietary education, increased physical activity, parental involvement and behavioral modification and studies focused on increased physical activity among subjects showed positive results. But the majority of studies were short-term and secondary prevention among children, not adolescents, not randomized, and without control. Few studies used validated questionnaires and process evaluation.

Conclusion : The development and application of evidence-based and feasible strategies in support of communities and families to the school-centered obesity prevention program are needed in the near future.

Background
: Osteoporosis and hyperlipidemia in postmenopausal women may develop due to a sudden decrease of estrogen. In general, women over 60, about 10 years after menopause, are at risk of continuous bone loss. However, many reports reveal that high body weight may have a preventive effect on bone loss. There are few studies that examine the effect of body mass index on bone loss in aged Korean women. The aim of this study was to show the effect of body mass index on bone loss in aged Korean women.

Methods : We evaluated 510 women aged over 60 who visited a health care center of a university hospital in Seoul from January 1999 to December 2004 to determine the effects of body mass index on bone mineral density in aged Korean women. We measured anthropometrical characteristics, BMD of lumbar spine, markers of bone turnover, and FSH of the subjects.

Results : The higher body mass index, the greater BMD at lumbar spine. But the levels of alkaline phosphatase, osteocalcin and deoxypyridinoline had no significant differences. The FSH level was also low in the high body mass index group. The BMI was positively correlated with BMD (P＜0.01) by Pearson's correlation matrix. The total alkaline phosphatase also had a significant negative correlation with BMD. The levels of FSH had negative correlation (P＜0.01) with BMD.

Conclusion : Higher body mass index groups showed higher BMD with lower FSH levels. Further prospective studies considering the endocrinologic association with body weight, BMD and FSH level will be needed.