Background
: The research is to find out the object of Medical Phone Counsel rational and satisfactory by investigating in local clinic the actual state of Medical Phone Counsel, which is a form of medical care between doctor and patient, and by grasping the difference of expectation and recognition between doctor and patient on Medical Phone Counsel which is one of the service items of Attending Physician Registration System which is to be put into effect in near future.

Methods : This research conducted a self-administered questionnaire targeting all practitioners to the number of forty four who gave primary care in Kangnung city from August to September in 1999, and each twenty patients per practitioner. This research compared and analyzed the difference of recognition between doctor and patient on the following contents of Medical Phone Counsel; General Characteristic, Frequency, Contents, Time, Satisfiability, For or Against the Medical Phone Counsel to be executed under Attending Physician Registration System and Expectations.

Results : The questionnaire for doctor had a 70.5% of response rate, and the one for patient 17.2%. The 40.7% of the practitioners took a Phone Counsel actively, the 55.6% took part in Phone Counsel passively and the rest 3.7% did not participate in it. The 74.2% of them took this counsel for less than three minutes. Regarding recognition on Phone Counsel, the 48.1% of them answered that they executed it as it is their duty and the 48.4% responded that they took it reluctantly in spite of their busy business. The 3.2% answered that it is not their duty. Among those in favor of Phone Counsel under Attending Physician (or Prime Doctor) Registration System, the 28.6% agreed as it is their own duty and the 71.4% was for it subject to economic compensation. While, the 62.9% of the patients answered that they had never experienced the Phone Counsel, and the 34.4% responded that they had experienced it one or two times in a year. Among those who had experienced Phone Counsel, the 46.4% was satisfied with it. As far as the difference of expectation and recognition between doctor and patient on Medical Phone Counsel is concerned, only 45.2% of the practitioners were in favor of Medical Phone Counsel under the Attending Physician Registration System. While, the 70.1% among the patients was in favor of its execution. These two values showed a significant difference between doctor and patient (P<0.05), And the 83.9% of the practitioners insisted that the charge should be paid against Phone Counsel, and only 56.2% of the patients insisted the same. There was also a significant difference between two values.(P<0.05).

Conclusion : The practitioners were taking part in Medical Phone Counsel at any form. To the contrary, most of the patients were not. As far as the systematization of Phone Counsel is concerned, most of the practitioners had mental reluctance if there is no economic compensation. On the other hand, most of the patients and high expectation regardless of economic matters. If Medical Phone Counsel becomes systematized, it is expected that there will be a great trouble between its supply and demand.

Background
: All individuals chronically positive for HBsAg are not always complicated by advanced liver diseases and have various differences in their clinical progression. In an attempt to find out the factors determining clinical progression, comparative analysis was made among four groups (asymptomatic, chronic hepatitis, liver cirrhosis and hepatocellular group) according to the titers of HBeAg and HBeAg, and the presence or absence of HBeAg and HBV-DNA.

Methods : This study included 198 males and 96 females who visited Asan foundation Kangnung Hospital from Sep. 1, 1996 to May 31, 1998 and the subjects were HBsAg-positive for at least six months. They were classified into four groups on the basis of their worst results after CBC, LFT, and abdominal ultrasonography carried out on two occasions at least at three-month intervals. For confirmation of hepatoma abdominal CT and hepatic angiography were performed. Among the four groups compared were the mean titers of HBsAg and HBeAg, and positive rate of HBeAg and HBV-DNA.

Results : A total of 294 subjects was diagnosed as having no symptoms in 169(57%), chronic hepatitis in 71 (24.1%), liver cirrhosis in 41 (13.9%), and hepatoma in 13 subjects (4.4%). The more advanced in age (p<0.01) and sexual preference of males (p<0.05) were found to be associated with worse liver conditions. The Asymptomatic Group showed lower titers of HBsAg (p<0.01) and HBV-DNA (p<0.01). In the case of subjects without HBeAg, the presence of HBV-DNA was significantly linked to chronic hepatitis and liver cirrhosis (p<0.01). Based on age by multiple regression, the group of less than 29 years of age had higher titer of HBeAg as determinant factor for clinical progression, 30-39 years of age the presence of HBV-DNA, 40-49 years of age the presence of HBeAg, the presence of HBeAg and male, the group of more than 50 years of age had higher titers of HBeAg, the presence of HBV-DNA, and higher titers of HBsAg.

Conclusion : The present study revealed that clinical progression depended upon the titers of HBsAg and HBeAg, and the presence or absence of HBeAg and HBV-NDA in the same age group, and sexual preference for males as well as older age counted for clinical worsening of chronic HBsAg-positive subjects.