Background
: With the population aging, osteoporosis is becoming a major health issue. Although not as common as women, osteoporosis and its clinical end point of fracture are significant health care concern in men. Despite the considerable public health burden, our understanding of their pathogenesis is incomplete, and several factors known to affect bone metabolism in men are still controversial. So this study was made to investigate relationship between testosterone and bone mineral density in men.

Methods : This was a cross-sectional study of 432 men undertaken health screening program in Pundang CHA General Hospital from January 2000 to December 2000. We surveyed information concerning exercise and consumption of alcohol and smoking by means of self questionnaire records. Serum total testosterone, SHBG, and osteocalcin were measured at a fasting state. Second morning urine was tested for deoxypyridinoline. BMD was assessed using pQCT.

Results : FTI (free testosterone index) was positively correlated with BMD (r=0.265, P＜0.01). Age, osteocalcin, SHBG, and urine deoxypridinoline were negatively correlated with BMD (r=-0.397, P＜0.01, r=-0.121, P＜0.05, r=-0.214, P＜0.01, and r=-0.126, P＜0.01). BMI and total testosterone had no significant correlation with BMD, and there were no apparent association among the level of alcohol and tobacco use, regular exercise and BMD. FTI was not independently correlated with BMD after age, BMI and urine deoxypyridinoline were adjusted, but showed a trend to significantly predict BMD (β=0.10, P=0.052).

Conclusion : These data suggest that FTI may play a role in determination of BMD in men, allowing the potential for clinical intervention. But further investigation of the role of testosterone in bone metabolism in men is necessary.

Background
: The age-related increase in fat mass seems related to decrease in hormone level. Few studies have been done in Korea concerning the association between testosterone, GH (growth hormone) and fat mass. This study was undertaken to evaluate the relationship among testosterone, IGF-1 and fat mass.

Methods : The study was performed from February to October 2001 in the Health Screening Center of Pundang CHA Hospital with 243 men as subjects. Fat intake was measured through interview with diet therapist and other data were obtained by self-questionnaire. Fat mass was measured using Inbody 3.0 and the level of total testosterone, SHBG and IGF-1 in serum were measured.

Results : Smoking was negatively correlated with fat mass and WHR (waist to hip ratio) (P＜0.05) and fat intake was positively correlated with fat mass (P＜0.05). Fat mass was negatively correlated with total testosterone, calculated free testosterone, and SHBG (r=-0.26; P＜0.01, r=-0.15; P＜0.05, r=-0.31; P＜0.01). WHR was positively correlated with age (r=0.26; P＜0.01) and negatively correlated with total testosterone, calculated free testosterone, and IGF-1 (r=-0.24; P＜0.01, r=-0.20; P＜0.01, r=-0.16; P＜0.05). After adjustment for age, body mass index, smoking, and fat intake, the calculated free testosterone and IGF-1 were independently negatively correlated with fat mass (β=-0.072; P＜0.01, β=-0.0035; P＜0.05) and WHR (β=-6.9E-04; P＜0.05, β=-4.0E-05; P＜0.05) but, total testosterone and SHBG were not independently correlated with fat mass and WHR.

Conclusion : The results indicate that the calculated free testosterone and IGF-1 can be independent determinants of fat mass and WHR in middle-aged men.

Background
: This study was done to investigate the clinical risk factors of delirium in general hospital's elderly inpatients.

Methods : A case-control study design was used. Forty cases and age-sex matched 120 controls were identified using hospital discharge data from June 1995 to May 2001. The controls were selected during the same period. The clinical records of each subject were reviewed using discharged disease code to select cases. Subsequently, the data were recorded from clinical records.

Results : The subjects admitted with delirium with delirium tended to have increased age (P=0.007), hypoxia (P=0.018), low hemoglobin(P=0.011), sleep disturbance(P=0.001), more ADL total dependence(P=0.018), diagnoses with infections (P=0.006), diabetes (P=0.046), and hypertension (P=0.041). Above risk factors seemed to be clinically associated with delirium.

Conclusion : These findings indicate that rapid infection control, maintenance of good sleep hygiene, well-controlled diabetes and hypertension, and correction of hypoxia may help to prevent delirium in general hospital's elderly inpatients.

Background
: Although it has become obvious that male osteoporosis represent a public health issue, few studies has been done in Korea concerning the association between grip strength and bone mineral density(BMD) in men. This study was undertaken to enforce the necessity of muscle strengthening exercise program to improve BMD in middle-aged men by evaluate the association between grip strength and BMD.

Methods : The study was performed from January to December 1998 in the health screening center of CHA hospital with 174 men who measured both BMD and grip strength. BMD was measured at the proximal and distal radius of the dominant hand using Osteoplan p-DXA and grip strength was measured from the dominant hand using dynamometer. Daily calcium intake was measured through the interview with the diet therapist. Other datas were obtained from the questionnaire.

Results : We found a significant positive correlation between grip strength and BMD of distal and proximal radius(r=0.208; P<0.01, r=0.2555; P<0.01) and a significant negative correlation between age and BMD of distal and proximal radius(r=-0.313; P<0.01,r=-0.190; P<0.05). There was no correlation between calcium intake and BMD. BMI was correlated significantly only with BMD of distal Radius(r=0.194; P<0.05). There was no significant difference in BMD either by smoking or exercise. The multiple regression analysis showed that grip strength was independently correlated with BMD of the proximal radius significantly(β=1.731, P<0.05), but not with BMD of the distal radius after adjusting the confounding variables.

Conclusion : In conclusion, there is a significant correlation between grip strength and BMD in middle aged men. Therefore it can be safely concluded that it is helpful to carry out muscle strengthening program to improve muscle strength and increase BMD for preventing male osteoporosis.

Background
: The prevalance of coronary heat disease is significantly higher in men than in premenopausal women of the same age. Impact that endogenous androgens have on serum lipid has many arguments and few researches were made in Korea. So this study was made to investigate correlation between total testosterone and serum lipid known as effect on cardiovascular disease.

Methods : This was a cross-sectional study on 560 middle aged men undertaken health screening program in Pundang General Hospital. Korea for June 1999 to June 2000. We surveyed informations concerning exercise, consumption of alcohol and smoking by means of self questionnaire records and total testosterone and serum lipid were measured at fasting state.

Results : Body mass index was positively correlated with total cholesterol and triglycerides(r=2.023;P<0.01, r=0.229;P<0.01) but negatively correlated with HDL-cholesterol (r=-0.284;P<0.001). Total testosterone concentrations were negatively correlated with total cholesterol and triglyceride(r=-0.096; P<0.05, r=-0.145; P<0.01) but positively correlated with HDL-cholesterol(r=0.155; P<0.001). Total testosterone concentrations were independently correlated with HDL-cholesterol after age and body mass index were adjusted(B=0.734; P<0.05). And after statistical adjustment for age, body mass index, exercise, smoking and alcohol, total, testosterone concentrations were significantly correlated with triglyceride(B=-10.467; P<0.05).

Conclusion : The result indicate that total testosterone can be a independent determinant of HDL-cholesterol and we expect that appropriate maintenance of total tetosterone concentrations will have a protective effect for cardiovascular disease.

Background
: The cognitive subscale of the Alzheimer's Disease Assessment Scale(ADAS-Cog) has been extensively validated in assessing cognitive function in patients with Alzheimer's Disease (AD) and used as an efficacy measure in clinical trials of AD. There is a need for additional data on the relationship between cognitive performance and other measures of dementia to fully assess the value of the ADAS-Cog as a measure of treatment efficacy.

Methods : We used data from 53 AD participants in 8 multicenter clinical drug trials to examine the distribution of baseline ADAS-Cog scores in relation to Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDES), Katz Index of Activity of Daily Living(ADL), Lawton Instrumental Activity of Daily Living(IADL), Geriatric Depression Scale(GDS) and Mini-Nutritional Assessment(MNA).

Results : The ADAS-Cog score was statistically significantly correlated with MMSE (T=-0.755, P<0.001), GDES(R=0.403, P<0.003), ADL(R=-0.532, P<0.001), IADL(R=-0.626, P<0.001) and MNA(R=-0.427, P=0.004) scores. But GDS scores were not associated with ADAS-Cog scores.(R= -0.123, P=0.396)

Conclusion : This study characterizes the relationship between ADAS-Cog scores and other commonly used measures of dementia in AD patients. As expected, baseline scores on ADAS-Cog and MMSE demonstrated significantly high correlation. The relatively weaker correlation between ADAS-Cog and GDES scores may be related to the fact that GDES does not evaluate cognitive function only. There are also significant correlations between ADAS-Cog and ADL, IADL, and MNA which indicate the severity and progression of dementia in AD patients. Further studies with larger samples including cognitive function of broader spectrum need to confirm the findings in this study.

Background
: Several studies have reported that muscle strength and bone mineral density have a significant positive correlation and most previous literature on muscle strength and bone mineral density examined their association. To evaluate the association between grip strength and radius bone mineral density, more precise PQCT was used rather than SPA or DEXA.

Methods : The study was performed from June to August 1999 in Pundang community with 154 postmenopausal women who undertaken osteoporosis screening program who participated in this study. Bone mineral density was measured at the radius using PQCT (peripheral quantitive computed tomography). Grip and pinch strength were measured in both the dominate and nondominant hand using a dyanometer. Other data were obtained from the questionnaire.

Results : Grip and pinch strength of the dominant hands were significantly higher than the nondominant hands. There was no significant difference in bone mineral density by exercise and fracture history. Age-adjusted partial correlation analysis indicated a significant positive correlation of radius BMD with dominant hands grip strength. Significant positive correlations also were found between radius BMD and pinch strength.

Conclusion : Subjects with stronger grip strength had a low BMD. There was a significant positive correlationship between bone mineral density and dominant hand grip strength. The data suggest that grip strength is a weak predictor of radius bone mineral density and provide a feasible way of predicting it.

Background
: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant de-spite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalence of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms.

Methods : The subjects were 409 people who underwent esophagogastroduodenoscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characteristics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking, alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were analyzed by Chisquare test.

Results : CLO test was positive for 264(64.5%) in total, 156(65.3%) in males, 108(63.5%) in females, not different significantly in each group. The frequency of CLO test positive was 53.3%(under 30 years old), 64%(thirties), 66.9%(forties), 67.9%(fifties), 48%(over 60 years old). H. pylori infection increased slightly as age increased, but decreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alcohol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively.

Conclusion : The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection was not significant biostatistically.

Background
: With the rapid increase in the number of the aged population, curable or controlled diseases were treated as aging process because of the difficulty of early detection and treatment of disease and specificity of elderly patients. We help manage elderly patients by studying their frequency of common known disease and hidden disease that would enable the curable diseases to be detected early, and noncurable disease to be controlled.

Methods : The subjects included 128 patients over 60 years old who had completed structured questionnaires and we reviewed chart records among 208 patients registered from January 1997 to July at the Health Screening Center of a general hospital in Kyonggi-do. Known diseases were based on charts recorded through structured questionnaires and hidden diseases were based on health screening results and overall geriatric assessment data.

Results : The number of patients was 128 in which male was 47 and female was 81. The ratio between male and female was 1:1.72 and the average age was 66.0 years. In the order of frequency, the most common known diseases were hypertension, arthritis, G-I disturbance, diabetes mellitus, chronic obstructive pulmonary disease, heart disease, depression and the hidden diseases they were arthritis, G-I disease, depressive mood, malnutrition, hypertension, osteoporosis, hearing loss, hypercholesterolemia, hypomagnesemia, incontinence, anemia, decreased cognitive function.

Conclusion : We assessed the characteristics of multiple pathology in geriatric patients and realized that it was important to manage aggressively those with a hidden disease that can be treatable after early detection through overall geriatric assessement.

Background
: Among the outpatient clinic visitors who were diagnosed as "your liver is fragile or weak" by Oriental doctors, many patients asked Western medical doctors of the opinion about their status of liver. No study exists on the correlation of Oriental and Western medicine concerning liver disease. The authors have investigated to evaluate the correlation of liver disease which was diagnosed in Oriental and Western medicine.

Methods : From January to March 1997, 122 subjects had undergone health undergone health screening program in Oriental-Western Integrated Health Promotion Center of Pundang CHA General Hospital. Liver dysfunction in Oriental medicine was diagnosed by an Oriental medical doctor in the Center. Cases were reviewed and compared with laboratory and abdominal ultrasonographic findings on chart record.

Results : Of the total 122 subjects, 15 were diagnosed as having normal liver and 107 as having liver dysfunction in Oriental medicine. Comparing these two groups, there was no statistical significant difference. No statistical significance was found between liver dysfunction in Oriental medicine and HBaAg, HBsAb, HBeAb, alcohol drinking. 43 subjects had findings of fatty liver on abdominal ultrasonography in which. 26(21.3%) were mild, 14(11.5%) moderate, and 3(2.5%) severe. There was no statistical difference between liver dysfunction in Oriental medicine and fatty liver. Among the abnormal findings on abdominal ultrasonography, 43(35.2%) were fatty liver, 3(2.5%) polyp of gallbladder, and 2(1.6%) were gallstone. There was no statistical significance between liver dysfunction in Oriental medicine and abdominal abnormalities on ultrasonography. 58 patients were diagnosed as having liver disease by laboratory test and sonographic finding among which 43(35.2%) were fatty liver, 7(5.7%) hepatitis, 3(2.5%) alcoholic liver dysfunction, 3(2.5%) polyp of gallbladder, and 2(1.6%) were gallstone. There was no statistical significance between liver dysfunction in Oriental medicine and liver disease in Western medicine.

Conclusion : The result suggests that the meaning of liver dysfunction in Oriental medicine is different in Western medicine.

Background
: It was known that physical illness and depression due to cognitive function defects increase in the elderly. This study was designed to evaluate the prevalence of depressive mood, associated factors and to help understanding recent trends of the depressive elderly.

Methods : We selected 108 subjects over 65-year-old who visited Health Promotion Center, Pundang CHA General Hospital for geriatric health evaluation from Mar. 1996 to Feb. 1997. We analyzed Geriatric Evaluation Record to know the effect of sociodemographic factors, life styles and geriatric medical factors by Geriatric Depression Scale(GDS).

Results : The result showed that depressive mood appeared 20(37.0%) in male, 35(64.8%) in female and 55(50.9%) in total among 108 subjects. Factors associated with deprssive mood of the elderly were occupation(p<0.05), regular exercise(p<0.001), nutritional status(p<0.05), functional status and alcohol drinking.

Conclusion : The prevalence of depressive mood of the elderly was 50.9%, and the depressive mood have been affected more for the elderly who was out of work, not doing regular exercises and got high nutritional risk. Further study is required to know other factors influencing on depressive mood of the elderly.

Background
: Hypertension is common chronic illness and causes serious complication so it require accurate diagnosis. Therfore this study was done to estimate predictive value that diagnosed hypertension by first checked diastolic blood pressure.

Methods : From May 1st, 1993 to July 31st 1993, for the 552 peoples not previously diagnosed to be hypertensive through workers of Kyung-buck Andong area. We checked the first blood pressure and 2nd, 3rd blood pressure after 15 days, 30 days each other. We also checked about sex, age, height, weight, alcohol drinking, smoking, family history of hypertension, diet habit, amount of stress, previous symptom. Data were analyzed by SAS/PC.

Results : In the first BP checking, the people whose diastolic BP over 90mmHg are 22.5%(124 per 552), and definite hypertension people in that group were 72.6%(90 per 124). When the first checked diastolic BP is over 90mmHg, as one grew older, diastolic BP is higher, the diagnostic predictive value of hypertension was increased. The people diagnosed hypertensive in the group that first diastolic BP is below 90mmHg were 5.4%(23 per 428). The prevalence of hypertension is 20.5%(113 per 552).

Conclusion : Therefore it requires that Family Physician must check precisely first BP and follow up regularly. Although when the first checked BP is normal, he also has to check BP 3 times at least.

Background
: Atopic disease is well known disease entity which occurs with concurrent various illness at infancy through adulthood periods. It is related to family history and family function. In view of biopsychosocial aspects, they also have focused on its importance of environmental factors. Therefore we carried out this study for the purpose of seeking preventive measures.

Methods : From April 1 to September 30 1993, 205 mothers of atopic patients who visited a local dermatologic clinic were selected and asked questions after then they answered our questions which are composed of patient's age, sex, family history, seasonal variations, aggravating factors, mother's age, education grade, separation experience, family APGAR score, etc.

Results : There were more male than female with male(53.2%) to female(46.8%) ratio of 1.1:1. The children between 0~3 age were 32.2% and age distribution was 0~20 age. Age distribution on patient's mother was 25~51 age, the most common group was high school-educated among age 3rd decades. As a result of the survey of family history, 54.6% of all cases had family history of allergic diseases. Atopic dermatitis was most common(29.8%), the next was urticaria(9.7%) followed by allergic rhinitis(7.8%), asthma(3.9%) and food allergy(3.4%). The 37% of patient's mother had hand eczema. The aggravating factors of atopic dermatitis were elevation of interior temperature and turning point of seasons. In atopic family, dysfunctional family was 40% and the rate of separation experience in Mother-Child Relationship according to family APGAR score was 16.1%.

Conclusion : This results shows that 54.6% of atopic patients had family history of allergic diseases. As an environmental factors, Mother-Child Relationship is important influence on onset, aggravation and prevention of atopic disease.

Background
: The study of serum total cholesterol for adults are abundant, but it was not for children and adolescents. Thus, we carried out the study of serum total cholesterol depending on sex, age and body measures for healthy children and adolescents.

Methods : From April 1, 1993 to April 30, 1993, we requested health examination for elementary schools, middle schools and high schools located in Taegu. Among them, 249 students accepted it and we studied for them.

Results : Among 249 students, males were 118(47.4%) and females were 131(52.5%). According to age, elementary school boys(girls) were 122(49%), middle school students were 25(10%), and high school students were 102(40.9%). The mean of serum total cholesterol of study subjects was 167.3mg/dl. In cases of males, it was 161.2mg/dl and females, it was 174.8mg/dl. The mean of serum total cholesterol of females was significantly higher than males. The mean of serum total cholesterol was significantly different depending on sex and height, as increasing of relative weight the mean of serum total cholesterol trended to increase. The mean of serum total cholesterol trended different levels depending on age and weight.

Conclusion : In the study of mean serum total cholesterol for children and adolescents depending on sex, age and body measures, the mean of total serum cholesterol was significantly different depending on sex, height and relative weight. In children and adolescents, it is important to effort for collection of reversible factor, relative weight and serum cholesterol after screening test.

Background
: In modern society, adolescent problems are increasing, so we carried out this study in order to know depression tendency and relationship of family function and school satisfaction.

Methods : This study was surveyed questionnaire to 216 students of one girl's middle school in Daegu. Depression tendency was based upon BDI as cut off point 21 and family function was based upon Family APGAR Score.

Results : Average of BDI score in students was 17.0 and depression tendency ratio was 31.5% and school satisfaction ratio was 59%. In Family APGAR Score of students, severely dysfunctional 0-3 was 22.7%, moderately dysfunctional 4-6 was 56%, highly functional 7-10 was 21.3%. Relationship of Family APGAR Score and BDI was statistically significant(P<0.05). and Family APGAR and school satisfaction was also statistically significant(P<0.05).

Conclusion : There was significant relationship between Family APGAR Score and depression tendency and school satisfaction in students. So comprehensive care in primary care must have concern about family function and depression tendency of students.

Background
: In our country, obesity, hypertension, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia are increasing according to the change of dietary patterns and other causes such as economic growth. So we investigated the prevalence of these diseases for a part of the insured persons in Taegu.

Methods : We checked height, body weight, blood pressure, fasting blood sugar, fasting cholesterol, fasting triglyceride, hemoglbin, serum protein, transaminase, urine sugar, urine protein, urine RBC, Pap smear for the 3,005 insured persons participated in health examination at Keimyung University Dongsan Medical Center, Taegu.

Results : The prevalence of obesity showed 27.5% in all, 11.3% in males, 33.0% in females and 5th decade is the highest as 32.3%. The prevalence of hypertension showed 20% in all, 27.0% in males, 18.6% in females and among the aged over 70 years is the highest as 34.3%. The prevalence of diabetes mellitus showed 2.8% in all, 3.3% in males, 2.6% in females and among the aged over 70 years is the highest as 5.3%. The prevalence of hypercholesterolemia showed 43.5% in all, 44.3% in males, 43.2% in famales and 5th decade is the highest as 54.3%. The prevalence of hypertriglyceridemia showed 2.4% in all, 4.4% in males, 1.7% in famales and 5th decade is the highest as 3.6%. The relative prevalene of hypertension was 2.6 in hypertriglyceridemia that was greater than that of other risk groups and relative prevalence of hypercholesterolemia was 3.6 in hypertriglyceridemia that was greater that that of other risk groups. And the relative prevalence of Diabetes Mellitus was 2.1 in hypercholesterolemia that was greater than that of other risk groups and the relative prevalence of hypertriglyceridemia was 3.6 in hypercholesterolemia that was greater than that of other risk groups.

Conclusion : The sequence of the prevalence in major diseases is hypercholesterolemia, obesity, hypertension, diabetes mellitus and hypertriglyceridemia. We measured the relative prevalence, so we had come to know the grade for the prevalence.

Background
: This study was performed to examine the clinical usefulness of abdominal ultrasonography in health screen.

Methods : Medical records and health screen records of 405 cases without chief complaint which were visited at general health screening center of Dongsan medical certer during 4 month - period from may, 1993 to august, 1993 were analyzed.

Results : We experienced 77% of normal ultrasonographic finding and 33% of abnormal ultrasonographic finding in 405 cases examined. We reviewed the results of the most common abnormal ultrasonographic finding in order of each organs, which were detected fatty liver in 17% : gallstone in 4% : renal cyst in 1.7% : splenomegaly in 0.7%. The classification of abnormal ultrasonographic finding were fatty liver, chronic hepatocellular disease, gall stone, clonorchiasis, liver cyst and renal cyst in order of decreasing frequency.
Sensitivity of ultrasound study in clonorchiasis was 43% and positive predictive value was 43% but specificity was 98%.

Conclusion : These results suggest it is well worth employing sonograph for health screening purposes especially for early detecrion of fatty liver, chronic hepatocellular disease, clonorchiasis, gallbladder stone, renal cyst, renal stone and splenomegaly. And analysis aspect expense-effect are required.

Background
: Osteoporosis is the most common metabolic disease of the bone, and thought as public health problem due to its high prevalence and cost. Family physician as primary care physician is much interested in the osteoporosis. so we studied the rate of osteoporosis, severity and related risk factors of osteoporosis from high risk postmenopause women, in order to be helped in early diagnosis, treatment and prevention of osteoporosis.

Methods : Among 706 patients who have taken Bone Mineral Density examination(DEXA) from Nov. 11, 1992, to Jul. 31, 1993 at Dong San Medical Center, we selected 102 natural postmenopause women who were not related to 2nd osteoporosis. The data was gathered from the BMD examination, qustionnaire and chart review. these data were analyzed using SAS/PC stastistic program.

Results : The mean age is 57.7 years and postmenopause age is 47.6 years. Osteoporosis was defined when BMD of patient was below 90% of age-matched control value. Number of osteoporosis and normal group is 55 and 47, respectively. the rate of osteoporosis was 53.9%. The statistically significant difference was revealed between two groups in mean age, postmenopause age, duration of menstruation, duration after menopause, oral pill history, kyphosis and fracture history. In the multiple regression of risk factors to osteoporosis, height and postmenopause age had significant relation to the osteoporosis, and weight and Body Mass Index had trended to osteoporosis.

Conclusion : Family physician should consider there risk factors of the osteoporosis when postmenopause women visit. We think that the more precise study for risk factors to osteoporosis is essential.

Background
: Recently, general health examination is performed in rural area as well as urban area. Many persons recognize that early detection & protection of diseases are more important than treatment after disease occurrence and then many office workers receive general health examination. Our study was done to find the difference between health problems of rural & urban areas.

Methods : We compared each items of results of general health examination from June 1, 1993 to August 31, 1993 between 132 men who received general health examination in Dongsan medical center and reside in Taegu city and 145 men who received general health examination in Andong General hospital and reside in Kyeung-Book province.

Results : 1. Abnormal findings of chest X-ray(urban 5.3%, rural : 15.9%), anemia(urban : 1.5%, rural 9.7%), decreased liver function(SGOT urban ; 4.5%, rural ; 11.0% and SGPT urban : 14.4%, rural ; 29.7%) were statistically different between two areas.
2. Hypercholesterolemia(above 240mg% urban ; 22.7%, rural : 11.1%), abnormal ECG findings(urban ; 18.9%, rural ; 6.9%), abnormal fasting blood sugar level(110~139mg% urban ; 21.2%h, rural ; 13.1% and above 140mg% urban ; 3.8%, rural ; 2.8%) were statistically different between two areas.

Conclusion : We have a conclusion that family physician must recognize the results of health problems between urban and rural areas for good primary practice in each area.

No abstract available.

Background
: Recently epidemiologic study of chronic diseases on island inhabitants is very lack. So we searched for the prevalance rate of chronic diseases, classification of chronic diseases and relationship between chronic diseases and health risk factors on island inhabitans.

Methods : This survey was executed from October 10th. 1992 to October 15th. 1992 on 477 Docho Do inhabitans and the results were as follows.

Results : The prevalance rate of chronic diseases on island inhabitants was 48.8%. The difference general characteristics between chronic disease group and non-chronic disease group was statistically insignificant.
There was significant difference between hepatitis vasccination and chronic disease in relationship of health risk factor and chronic disease group. (P<0.05)
The chronic diseases on island inhabitants were arthritis, hypertension, heart disease, gastric disease, liver disease, etc.

Conclusion : We knew result from this study that prevalance rate of chronic disease and the relationship of health risk factor and classification of chronic disease on island inhabitants.
Further studies which can overcome for the limitation of this survey should be performed.
So we need more attention to the health examination on island inhabitants.

Background
: It is important to analyze the stress amount and content of life event according to family life cycle through the recent experience of life event in family practice, because it need to predict disease and understand the relationship among the family members. This study was attempted to establish data base for health promotion and disease management and assist perform the comprehensive and continuous care of the family practice.

Methods : The data were collected from married adult 486 of the above 20 age, from July to September, in 1992. Family life cycle by Duvall and S.R.R.S. by T.H. Holmes and R.H. Rahe was selected and analyzed the stress amount in terms of their recent experience of 43 kinds of life events and induced the 6 life event in the order of frequency, according to family life cycle.

Results : The result were summarized as follows
1. According to increase the family life cycle, mean stress amount was tending to decrease.
2. First 5 life events by frequency about 486 subjects were vacation(35.2%), christmas(28.2%), major change in argument with spouse(22.8%), minor violation of the law(18.7%), change in residence(17.5%).
3. Mean stress amount by abnormal life event associated with family life cycle was higher in diseased group rather than non-diseased group

Conclusion : There were some significant difference in mean stress amount and content of life event according to family life cycle. these finding have implication for the comprehensive and continuous care of the family practice.
It is important to calculate the stress amount in transitional zone. But this study was not noted the finding in transitional zone. Therefore further study in tansitional zone will be needed.

Background
: Knowledge and experience of the family physician who sees patient for the first contact care have an effect on the referral content and outcome. So we carried out this study to determine the relationship between the knowledge and experience of the physician and the referral content and outcome by comparing the physician according to grade.

Methods : We select March, May, September and December according to the seasons in order to stand for one year, from June 1991 to May 1992. We review the medical record of the 449 patients who visited our OPD of family medicine then referred to other specialties.

Results : Total referral rate was 3.7%. Compared referral rate according to grade, 3rd-year residents had lower referral rate than 2nd-year residents and staff has lower referral rate than residents.(P<0.05, P<0.001 respectively) The most common reason for referral was for diagnosis and treatment(29.4%), and then for treatment(24.1%), request by the patient(23.6%). The most frequently referred specialty was Internal Medicine(33.5%), and then Orthopedis, neurology. There was a trend to increase the treatment rate and relationship between the referral and minor problem by rising the grade of the physician.(P<0.001, P<0.01 respectively)
Agreement rate of diagnosis before and after referral was 63.3%. There was no significant difference according to grades. In the outcome of referral, no follow-up patient was most common(43.9%), and then improved(31.2%), admitted(18.9%).

Conclusion : There were significant differences according to grade in the treatment rate, relationship between referral and main problem before referral. But there were no significant differences in the reasons for referral, referred specialties, agreement rate of diagnosis before and after referral. In the referral rate, there were significant differences between 2nd-year residents and 3rd-year residents, and between residents and staff. Many biases may be in the study of the referral, so the study to minimize these biases is needed.

Background
: Diabetes mellitus is common disease that needs continuous control, therefore the patient is stressed by continuous diet therapy, exercise therapy, and drug therapy. But the study of diabetes mellitus related depression is rare. This study was done for evaluation of depression tendency of diabetes mellitus patient and its association factor by BDI questionnaires.

Methods : Based on selection group by 79 diabetes mellitus patients of Dong-San, An-Dong, Sung-So Hospital from June, 1, 1992 to August, 30, 1992.
And the control group was 79 non diabetes mellitus patients who is same sex and similar age(±3 years old) of sampling group.

Results : Depression tendency of diabetes mellitus group is higher than non-diabetes mellitus group(p<0.01) average BDI score of diabetes mellitus group of diabetes mellitus have significant relationship on BDI score(p<0.01). As cut off point of diabetes mellitus patient : depression set 21 point. Diabetes mellitus group is significant many depression patient-diabetes mellitus group 43(33.2%), non-diabetes mellitus group 18(22.8%).

Conclusion : Depression tendency of diabetes mellitus group is higher than non-diabetes mellitus group, therefore the family physician which provide continuing, comprehensive care in primary care must have concern about depression tendency of diabetes mellitus patient.

Background
: Life event is universal one which everybody experiences. Headache is one of the most common symptoms in primary care. However, there have been a few studies of the relationships between life events and headache.

Methods : Fifty-nine new patients were selected from the patients who complained headache and visited our family medicine clinic for periodic health examination from Mar. 1 to July 31, 1991. Control group was also selected from the population who did not complained headache and visited the clinic for periodic health examination from Sep. 1 to Sep. 30, 1991.

Results : The mean of total stress score in the study group are 935±657 and 489±333(P<0.0001) in the control group. There was a significant difference in the mean scores of negative stress events between the study and control groups(P<0.05). But there was no difference in the mean scores of positive stress events between the study and control groups. There were significant differences in marital problem, familial conflicts, health problem between the study and control groups.

Conclusion : There was a significant relationship between headache and life events. Also headache is associated with negative stressor, marital problem, familial conflicts, health problem.

Background
: Disturbance in family structure and function can predispose, precipitate and sustain illness in a family member. But there are few studies about the relationship between accidents and family function. So, we carried out this study to determine comparison of family function between illness and accidents by using FACES Ⅲ.
Family function was assessed using the family adaptability and cohesion evaluation scalesⅢ(FACES Ⅲ) questionnare. This questionnare were translated by Dr. Lim. et al.

Methods : As the accidents group, we took 71 cases among respondents(100 cases) who were admitted to Dept. of Orthopedics and as a control group we took 70 cases of adults who were admitted dept of Medicine in An Dong and Kyungsang Buk-Ko from June to September 1992. The study and control group charts audited and we compared two group about various demographic characteristics and FACES Ⅲ by questionnare.

Results : In cohesion, separated and disengaged family type were extremely common in study group(disengaged 94.4%, separated 5.6%) and control group(disengaged 98.6%, separeted 1.4%). this results was statistically no significant(p>0.05). In adaptability, chaotic and flexible family type were extremely common in study group(chaotic type 75.6%, flexible type 16.9%) and control group(chaotic type 68.6%, flexible type 21.4%). This results was not statistically significant between two groups. In the family type, no balance family type in two group and more common extreme family type(control 67.1%, study 69%) and next, mid ranged family group(study group 31.0%, control group 47%) there were not statistically significant in two groups.

Conclusion : Accidents might be lower family funtion as disease comparison to family funtion, there was no significant difference between two group.
Thus further studies with a large number of subjects should be performed.

Background
: The sinusitis is one of the common diseases in children. It tends to be chronic in nature. Also, It is difficult to treat because of its complications-serous otitis media, posterior nasal dripping, and chronic pharyngitis, etc. We carried out this study to assess the clinical characteristics of chronic sinusitis in children.

Methods : The authors assessed from chart review the clinical characteristics of 97 children with paranasal sinusitis who had visited out-patient clinic of Family Medicine Department, Keimyung University Dongsan Medical Center from January, 1990 to December, 1990.

Results : The children between 0~6 age were more than those between 7~15 ages, and there were more male than female with male to female ratio of 2.2:1. Winter was the most prevalent season in occurrence of paranasal sinusitis among four seasons. 7.2% of all cases had the past history of allergic diseases. bronchial asthma was most common, the next was allergic rhinitis followed by eczema and urticaria. The most common clinical manifestation was nasal obstruction (72.3%) followed by mouth open breathing (61.9%), snoring (58.8%) and rhinorrhea (52.6%). Throat injection(73.1%) was most common physical finding, the next was postnasal dripping(23.7%). Chronic hypertrophied tonsils and adenoid was the most common complication(69.4%), followed by serous otitis media(43.6%) and pneumonia(6.2%). On radiographic findings of maxillary sinus, bilateral lesion was more common than unilateral one. Opacity (49.5%) was common among local findings of paranasal sinusitis.

Conclusion : For treatment of chronic sinusitis and early detection of its complications effectively, We should take a careful history taking, physical examination, and radiologic examinations. We also suggest that the screening test for serous otitis media in patients with chronic sinusitis should be performed.

Background
: Although headache is one of the most common complaints in primary care, the relationship between headache and depression and anxiety is controversial. Therefore we carried out a study to determine the relationship between heatache and depression, and between headache and anxiety.

Methods : Seventy new patients were selected from the patients who visited our family medicine clinic to receive periodic health examination from March 1 to July 31 1991. We took Zung's scales.

Results : There were significant differences in the 11 items of SDS among 20 items between patients and the control group. There were significant differences in the mean scores of SDS and SAS between patients and control groups when compared between males and females of the two groups(p<0.01, p<0.001 respectively). There were significant differences in the total mean scores of the SDS and SAS between patients and the control group(p<0.01, p<0.001 respectively).

Conclusion : There was a close relationship between headache and anxiety as well as with depression, so a screening test was needed to screen depression and anxiety in the patients with headache. Further studies, which can overcome for the limitation of this study, should be performed.

Background
: The clinical content of family medicine, still an evolutionary process is very important in education and research in family practice. We carried out this study to analyze the clinical contents of primary care at Keimyung University Family Medicine Clinic.

Methods : In order to assess the contents of primary health care, we collected data from University-Based family practice clinics by chart review from June 1990 to July 1990. We used the ICPC coding system to classify the collected date.

Results : The total number of patients was 2981 of whom 1330 were male(44.6%) and 1651 were female(55.4%). The total number of reason for encounter(RFEs) was 4438. The average RFE per patient was 1.48. Among them cough, stomachache, rhinorrhea, for GI medication and headache ranked as most common. They could be classified to have 205 kinds of different diagnoses. The most common 20 diseases were 69.1% of the total. The disease systems were digestive system (30.9%), respiratory system(25.0%), neuromuscular system(16.5%) and circulatory system(7.2%) as per frequency. The diagnostic tests were 45 in number. The referral rate to other specialties was 9.0%, of which there were IM(25.4%), OB&GY(16.6%), OS(14.0%), Neurology(13.6%), GS(9.6%), Psychiatry(7.0%) and Urology(6.2%).

Conclusion : ICPC coding according to visiting purposes, demand for therapy, and health problems appeared to be very easy for primary care physicians to use.

Background
: It is known that gastrointestinal systems are very sensitive to psychosocial factors. The studies of correlation between gastrointestinal disorders and psychogenic illness have been performed. We studies the correlation between upper gastrointestinal diseases and depression, and upper gastrointestinal lesions and symptoms.

Methods : We assessed a group of 291 out-patients who received gastroscopy at the Department of Family Medicine, Dong-San Hospital, school of medicine, Keimyung university, and completed a questionnaire given from April to June, 1991. Data were gathered for epidemiologic status, sex, age, marriage, religion, occupation, education, alcohol, smoking, drug history, and the Zung self-rating depression scale was used to evaluate the patients' depression.

Results : The mean score of the depression scale was 43.40±10.73. Depression is more common in female than in male patients(p<0.01). Smokers had more gastroscopic abnormalities than non-smokers(p<0.05). Twenty symptoms were seen in the patients with upper gastrointestinal diseases. The most common symptom was hunger pain(49.8%), and the next were indigestion, belching, and nausea in that order. The score of depression was 43.44±11.40 for normal, 44.93±9.61 for gastroduodenitis, 38.81±9.14 for erosive gastritis and ulcer, and 55.22±10.96 for miscellaneous.

Conclusion : Depression might occur secondly to chronically recurring gastrointestinal disease. There was no significant difference in the prevalence of depression between normal and abnormal gastroscopic findings. Thus further studies with a larger number of subjects should be performed.

Background
: There have been a number of researches of hepatitis and parenterally infected NANB viral hepatitis where clonization was successful. Viral hepatitis C would be named by this process, and enzymatic-immunologic tests and serologic tests to diagnose viral hepatitis C were developed.

Methods : Seventy nine patients were selected from those whose HBsAg tests were negative and transaminase levels were abnormal from Jan. 1 to Sep. 30, 1991. We assessed the prevalence and clinical aspects of viral hepatitis C. We divided all patients into anti-HCV positive and negative groups and compared them with regard to symptoms of hepatitis, transaminase level and transfusion history.

Results : 22(27.8%) out of 79 patients showed positive anti-HCV, and the positive rate was highest in the group aged 60~69 years in men and 50~59 years in women. There was no sex difference. The positive rates of anti-HCV in the groups of positive and negative anti-HBc were 28.6% and 25.8%, respectively.

Conclusion : A positive rate of anti-HCV was higher(27.8%) in the patients with negative HBsAg & increased transaminase levels than in normal subjects. But, the number of case is small, so total morbidity is difficult to analyze.

Background
: It has been recognized that acute appendicitis in children is very difficult to diagnose, early diagnosis remains in the most challenging clinical issue in acute appendicitis in children. The very high incidence of perforation particularly in preschool children and the enormously increased morbidity in the perforated cases emphasize the importance of the problem.

Methods : This study is a clinical analysis of 49 cases with acute appendicitis under age 15 treated at the Keimyung University Dongsan Hospital, Taegu from 8.1, 1990 to 7.31, 1991.

Results : The incidence of acute appendicitis was increased as the age increased. The male to female ratio was 2:1(male 33, female 16) and there were 25 non-perforated case and 24 perforated cases. Bacterial culture from the peritoneal contented case and 24 perforated cases. Bacterial culture from the peritoneal contents in the perforated group was positive in 54.1% and E. coli was the most common organism.

Conclusion : There were much differences in clinical aspects between the perforated group and non-perforated group. Therefore, early diagnosis and operation of acute appendicitis in children is very important in clinical practice.