Background
There are few studies about association between the metabolic syndrome and smoking status (onset of smoking, duration, number of cigarettes per day, pack-years) in long-term smokers. And CRP level, a risk factor of the metabolic syndrome, is known to be higher in smokers than in non-smokers. This study was done to assess the association of smoking status and CRP level with the metabolic syndrome in long-term smokers. Methods: Healthy men aged 40 years old or more who visited the Samsung Medical Health Promotion Center were selected. We examined the participants' clinical characteristics by using self-reporting questionnaires, laboratory data, and Bruce treadmill test. We estimated the prevalence of the metabolic syndrome and identified the association between smoking status, CRP, and the metabolic syndrome by multiple logistic regression method. Results: The prevalence of the metabolic syndrome was higher in the long-term smokers (21.4%) than in the non-smokers (17.5%). The odds ratios of developing the metabolic syndrome were 2.46 (95% CI 1.31∼4.62) and 2.57 (95% CI 1.20∼5.50) in men who smoked 20∼29 and 30 or more cigarettes, respectively, compared with those who smoked 1∼9 cigarettes. And the odd ratio was 1.41 (95% CI 1.01∼1.97) in men who had high CRP level (≥0.3 mg/dl) compared with the normal CRP group. The number of cigarettes had statistically positive association with the CRP level (coefficient Ղ=0.059; P＜0.05). Conclusion: The prevalence of the metabolic syndrome was higher in the long-term smokers than in the non-smokers, and proportional to the number of cigarettes in the long-term smokers. The number of cigarettes smoked per day was correlated positively to the CRP level in the middle-aged Korean men. (J Korean Acad Fam Med 2008;29:94-101)

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
Menstruation is often regarded as a privilege for women allowing reproductive activity. However, abrupt hormonal fluctuations in menstrual cycle may cause distressing physical and psychological symptoms such as premenstrual syndrome (PMS). PMS is known to have a great impact on daily life activities and social functions, and might result in significantly decreased quality of life (QOL). In this study, we aimed to evaluate a relation between PMS and QOL in young adult Korean women. Methods: Self-administered questionnaires were distributed to a total of 514 women who were aged 16∼35 years and who were employed in an industrial complex located in Gyeonggi-do, Korea. PMS was assessed using diagnostic criteria recommended by the American Psychiatric Association. QOL was assessed using Korean health related Quality of Life Scale. The association between PMS and QOL was examined in 440 women using the two-sample t-test after excluding 74 women who were missing for variables essential for the assessment of PMS and QOL. Results: The prevalence of PMS was 7.3% (32 out of 440 women). Women with PMS had the worse QOL score in almost all domains of QOL except for spiritual health (physical function, psychological health, social function, pain, vitality, role limitation, health status perception, and health status change). Conclusion: There was a significant relation between PMS and QOL. The finding of significantly lower QOL in women with PMS suggests that PMS should be evaluated and treated actively in primary care. (J Korean Acad Fam Med 2008;29:108-113)

Background
The objective of the current study was to evaluate the association between fatty liver and osteoporosis in Korean postmenopausal women. Methods: We examined postmenopausal women who participated in a health screening test from April 2004 to November 2007. Data about lifestyle and current medical diseases and medications were collected from medical records and medical interviews. Body weight, height, waist circumference and blood pressure were measured. Bone mineral density (BMD) was measured by dual- energy X-ray absorptiometry and body composition analyzer and abdominal ultrasonography were conducted for each participant. Results: One thousand two hundred forty-five postmenopausal women were selected for this study. In postmenopausal women, the spine BMD levels (g/cm²) were significantly different in each subjects with normal (0.819± 0.004), mild (0.846±0.007), moderate (0.844±0.009) and severe (0.779±0.031) fatty liver adjusted for age (P＜0.01). The proportion of osteoporosis were significantly different in each subjects with normal (39.1%), mild (30.3%), moderate (31.6%) and severe (56.3%) fatty liver. A multiple logistic regression analysis was performed to determine the association between fatty liver and osteoporosis after age, body mass index, smoking, alcohol drinking and regular exercise. In severe fatty liver compared to the normal subjects of fatty liver, adjusted odds ratio was 3.6 (95% CI 1.2∼10.9). Conclusion: In severe fatty liver disease, the proportion of osteoporosis was increased and the bone mineral density was lower than the normal subjects of fatty liver. (J Korean Acad Fam Med 2008;29:114-120)

Background
The incidence of obesity is acutely increasing resulting in increased mortality rate and medical expenses among Koreans. But it is rare to find effective obesity management program, that are readily accessible by general local community residents. This study was aimed to develop and evaluate an effective and specialized obesity management program utilizing the local public health institutes. Methods: One hundred forty nine obese adults residing in Kwangju were enrolled in a tentative, 12-week scheduled obesity management program from August 2006 to October 2006. The program constituted of weekly education and practice by specialists, and exercise for more than an hour for 5 days a week. The effectiveness of the program was evaluated according to the change of body weight, body component, blood pressure, and serum lipid concentration. After the program was completed, each participant was surveyed on the degree of satisfaction and lifestyle changes. Results: Ninety participants (60.4%) completed the program to the end. The average decrement of body weight after the program was 1.9±1.5 kg. Eleven participants (12.2%) lost more than 5% of the initial body weight. The waist circumference and average blood pressure significantly decreased among the group who lost more than 5% of the initial body weight. The total cholesterol and triglycerides also slightly decreased among this group. Overall 87.3% of the participants were satisfied with the results of the program. The lifestyle of the participants had also changed by the program. Conclusion: The authors expect that establishing easily- approachable obesity management program in local public health institutes will make a great contribution to the maintenance of proper body weight and decrement of cardiovascular diseases among local community residents. (J Korean Acad Fam Med 2008;29:121-133)

Fitz-Hugh-Curtis syndrome (FHCS)-inflammation of the liver capsule (Perihepatitis) associated with genital tract infection-occurs in 4∼14% of patients with pelvic inflammatory disease (PID). Generally presenting as sharp, pleuritic right upper quadrant pain, usually but not always accompanied by signs of salpingitis. It needs differential diagnosis such as cholecystitis, pyelonephritis. The pathogenesis of FHCS is incompletely understood. But Neisseria gonorrhoeae and Chlamydia trachomatis are thought to be the primary causative germs of FHCS. We make a report about FHCS in 19-year-old woman who had been sexual history recently. (J Korean Acad Fam Med 2008;29:134-139)