Background
The most frequent hospital- related work injury is needle stick injury (NSI) that is likely to be experienced by most of the trainees during their residency, but not reported. Physicians under residency training were surveyed to identify the factors associated with non- reporting behavior of NSI according to health belief model. Methods: We surveyed 463 residents in a tertiary care teaching hospital in South Korea. A questionnaire on experiencing NSI, reporting behavior and the reasons for reporting behavior as done and collected between June and July 2004 via hospital groupware, AMCnet. The questionnaire was based on health belief model. Results: The e-mail questionnaire survey was received by 322 resident physicians and was completed by 43.8% (141). Among the responders, 88.7% (125) answered to have experienced needle stick injuries, and only 40% (50) had ever reported the incidence of NSI. The years of training, the infectivity of the patient in whom the needle was used, reporting mechanism or requirement and efficacy expectation were statistically significant factors for non-reporting behavior. Conclusion: The majority of the resident physicians did not report their NSI, and the variables affecting their underreporting behavior were evaluated by the health belief model. From this study, we learned that as the susceptibility of infection, the knowledge of reporting requirement and mechanism, and their expectation for the efficacies of reporting were higher, the reporting rate of their needle stick injury was likely to be higher as well. (J Korean Acad Fam Med 2007;28:500-508)

Background
C-reactive protein (CRP) is a nonspecific, but sensitive marker of systemic immune response. Many studies have suggested that CRP levels are associated with obesity and cardiovascular risk factors not only in adults, but also in children. We assessed the inter-relationships between CRP, obesity, and cardiovascular risk factors in Korean children aged 7 years old. Methods: A total of 126 children (40 overweight and 86 normal weight children) were recruited from seven elementary schools in Seoul and Gyeonggi-do. Physical examinations including various obesity parameters were done. Fasting and post-prandial venous blood was withdrawn for the chemistry. The hsCRP was measured by the Nephelometry. Results: The hsCRP was associated with body weight, body fat (%), body mass index (BMI), waist circumferences, hip circumferences and waist/hip ratio (P＜0.05). From the lowest to the highest quartile groups of hsCRP, mean fasting insulin levels (2.7⁑3.1μIU/mL, 2.6⁑2.1μIU/mL, 3.4⁑3.7μIU/mL, and 4.2⁑3.6μIU/mL, respectively)(P＜0.05) and HOMA-IR levels (0.60⁑0.70, 0.59⁑0.49, 0.74⁑0.84, and 0.95⁑0.83, respectively)(P＜0.05) increased. Serum lipid profiles were not associated with the hsCRP levels. Conclusion: In children aged 7 years old, the hsCRP was significantly associated with obesity and cardiovascular risk factors. (J Korean Acad Fam Med 2007;28:509-514)

Background
As obese population is increasing nowadays, research on blood pressure of obese children is being performed more frequently. However, there are only few research related to factors about blood pressure among obese children in Korea. The purpose of this study was to analyze the factors affecting blood pressure of obese children and adolescents. Methods: The subjects were elementary and middle school students diagnosed with obesity (n=1716). Height, weight, waist circumstance, body fat percent, blood pressure were measured. Family history and sexual maturity were investigated through the questionnaire. The relationship between the factors and the increase of blood pressure was analyzed. Results: Body weight was the most powerful factor among to factors related to increase of blood pressure (male r=0.45, P＜0.05, female r=0.37, P＜0.05). Also, height, percentage weight for height (PWH), body mass index (BMI) and waist circumference was correlated with the blood pressure. In multiple regression analysis, family history of hypertension and the sexual maturity were significant determinants of blood pressure in males after adjusting for weight. However, body fat percent was a significant determinant in females. Conclusion: Body weight was the most important factor which increased the blood pressure in obese children and adolescents in both sexes. But males and females had different factors related to the increase of blood pressure with the exception of body weight. (J Korean Acad Fam Med 2007;28:515-522)

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
This study was performed to evaluate the reliability and the validity of the Korean version of IPAQ short form. Method: Sixty-nine volunteer adults completed the questionnaires twice at 1 week interval, and the second one was compared to the results of Actical^Ⱂ in order to test validity. Results: The Korean version of IPAQ was accepted as a proper one by the IPAQ developers. Spearman Rho coefficients and Kappa values of test-retest reliability were 0.427∼0.646 (median 0.542) and 0.365∼0.620 (median 0.471), respectively. The Kappa values were above 0.4 in 5 out of 7 questionnaires. The more physically active by the short form questionnaire, the higher the measured value of the Actical^Ⱂ (P=0.039). Spearman Rho coefficient was 0.267 for the correlation between the results of the questionnaire and measured values by Actical^Ⱂ. Conclusion: The reliability and the validity of the IPAQ short form were proven. Follow-up studies are needed. (J Korean Acad Fam Med 2007;28:532-541)

Background
The clinical guideline for prehospital blood glucose measurement in hypoglycemia presenting with mental change has not been sure, maybe it has depended on individual decision. Therefore we was going to find out whether the difference of the vital sign between hypoglycemia and non hypoglycemia can give important message or not. Methods: Retrospective study was carried out from Jan 2004 to Dec 2005. The patients with mental change were divided into hypoglycemic group and non hypoglycemic group. Then we compared the difference of vital sign (Blood pressure, respiration rate, heart rate) based on paramedic run reports and medical records. Results: 66 person in hypoglycemic group were aged 60.92⁑16.90 on average. And 67 person in non hypoglycemia were 58.53⁑16.58. The difference of blood pressure, respiration rate is not significantly but only body temperature makes significant difference(P=0.014). Furthermore it was inclined that the lower body temperature was more likely in hypoglycemia(P＜0.001). Compared with over 36.0^oC, probability of hypoglycemia in less than or equal to 36.0^oC of temperature was more (OR: 54.28, 95% CI: 18.956∼155.464). Conclusion: The body temperature gives more significant information in Prehospital blood glucose measurements for hypoglycemic patients with mental change is not absolutely, but recommended in less than 36.0^oC. (J Korean Acad Fam Med 2007;28:542-546)