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
: Systematic care is not well provided in patients with terminal cancer and their families in Korea. Unnecessary hospitalization, multiple emergency room visits for controlling acute symptoms and the use of unqualified alternative care services are typical health care utilization patterns in such patients. We operated home-based hospice-palliative care services to help these patients and their families at a university-based family practice setting. Our experience is presented for the development of care model of hospice-palliative care services.

Methods : We investigated the demographic characteristics, the clinical findings and the utilization of medical care services of 72 terminally ill cancer patients before and after enrollment to hospice-palliative care unit from April 25, 2003 to April 21, 2005.

Results : The frequency of emergency room visits and the number of hospitalizations were decreased by Wicoxon Signed Ranks Test after the enrollment to home-based hospice-palliative care service unit. The duration of emergency room visits decreased from 7.7 hours to 0.3 hours and the duration of hospitalization decreased from 6.5 days to 0.0 days in median. The cost per emergency room visits decreased from 268,801 won to 153,816 won and the cost per hospitalization decreased from 285,491 won to 106,294 won in median.

Conclusion : Home-based hospice-palliative care services can be an efficient and effective model for the care of terminally ill cancer patients at a low cost.