Background
: Informing patients of their cancer diagnosis is a difficult task for most physicians and is a traumatic event from the patient's point of view. With the remarkable development of medical science, prolongation of life is possible and some cancers are curable. Also, expanding medical technology has enabled nonsurgical physicians to sample tissues for pathologic examination. The doctor's office may become the primary place where the patients are told their cancer diagnosis in the future. Because there is little empirical literature to guide the clinician an how to inform the patients, and in what context to present cancer diagnosis, analysis of the experience of groups of cancer patients may be valuable in gaining a wider view of this issue.

Methods : Forty patients with knowledge on their cancer, undergoing chemotherapy were interviewed to learn how patients were told, their feelings how and where they were told, and the patient's opinion on how other patients should be told in the future.

Results : 45% of forty patients were told by physicians, 30% by family and 25% by accident. 57.5% of patients were told in the hospital room. 30% in the doctor's office and 12.5% in the home. When asked whether they should be told about cancer diagnosis 87.5% of all respondents answered "yes", 12.5% answered "dependent on situation" and none answered "no". When asked who should tell the diagnosis, 80% answered "doctor", and 20% answered "family". When asked who should be informed of the cancer diagnosis first, 62.5% of respondents answered "the family", 22.5% "the patient", 15% "simultaneously".

Conclusion : This study showed that cancer patient should be told the diagnosis and the informant should be the physician. This study also showed that in contrast to western society, the family should be considered in the presentation of cancer diagnosis. In order to achieve active participation of the patient in the treatment of their cancer, the doctor should inform the patients their cancer diagnosis in a hopeful and caring environment with the support of their family.

Background
: The aged is steady increasing and now represent about 5.0% of our country population and utilize a majority of primary health care resources. The goal of this study was to suggest basic data for comprehensive and continuous management of geriatric patient increasing rapidly.

Methods : This study is a clinical analysis of 484 cases in geriatric center of Young-Dong severance hospital from October. 17, 1990 to June 1992, the outpatient's chart was reviewed and analyzed.

Results : The number of patients was 484 in which male were 206 cases (42.4%) and the number of female was 278 cases (57.7%) respectively. The largest age group of 70~74 was 176 cases(36.2%). The 3 most common past diseases were hypertension(34.0%), diabetes mellitus(15.2%), major operation history(13.2%).
The 3 most frequent chief complaints were arthralgia and myalgia(19.9%). headache(12.7%), chest pain(9.0%). In classifying diseases of cardio-vascular systems with 374 cases (33.3%), the 2nd was musculoskeletal disorder with 179 cases (15.9%), the 3rd was endocrine disorder with 154 cases (13'7%). The 3 most common present diseases were hypertension(21.8%), degenerative joint disease(15.9%), DM(13.7%). The most frequent medications were digestives with antacid and peptic ulcer drugs (22.8%), antihypertensive with diuretics (15.6%), analgesics (10.5%).

Conclusion : The study represents the symptom and disorder, diagnosis and treatment of people over 65. There were many differences in clinical aspects between the all age group and old age group. Therefore, the health problems of old age group had many characteristics, and then more study needed.

Background
: It has been estimated that up to 80% of all illnesses seen in a physician's office is due to psychosocial stress. But, previous instruments of stress measurement cannot assess patient stress rapidly in a busy practice. This study was attempted to develop a new instruments to measure the amount of stress in outpatient clinic setting in Korea

Methods : The data were collected from 387 subjects of 20 years of age and older, living in Seoul and Incheon city. The Questionnaire was composed of the Korean-translated BEPSI(Brief Encounter Psychosocial Instrument), reformed 30-items SRRQ(Social Readjustment Rating Questionnaire), and Lee's 98-items SRRQ.

Results : The reliability of Korean-translated BEPSI is demonstrated(Cronbach's alpha 0.84). The validity is measured through correlation with Lee's 98-items. The correlation coeffciency of translated BEPSI is 0.25 (P<0.01), and of reformed 30-items SRRQ is 0.98(P<0.01).

Conclusion : Korean-translated BEPSI and reformed 30-items SRRQ in Korean are applicable to rapid measurement of stress in outpatient clinic setting.

Background
: It has been well known that gastrointestinal systems are very sensitive to psychosocial factors, and the psychosocial factors are also influenced much by family function. Then we tried to fined out the relation between the family function, especially FACES(family adaptability and cohesion evaluation scale)III and gastrofiberscopic findings.

Methods : We assessed th100 responders to our questionnaire who received gastrofiberscopy at the Department of family Medicine and Internal Medicine, Paik Hospital, Interuniversity. The family function was assessed by 20 questions about the FACES III developed by Dr.Olson and also the frequency of six clinical symptoms were checked.

Results : Gastroscopic results were as follows: gastroduodenitis 74%, ulcer 8%, cancer 15% , others 3%. And the age distributions was ; gastroduodenitis and ulcer hold larger proportion from 4th to 5th decade and cancer was high from 6th to 7th decade. Grouping the subject families by cohesion scale 58% was disengaged family, 23% was separated, 15% was connected, 4% was enmeshed, and by adaptability scale 35% was structured family, 32% was flexible, 17% was rigid, 16% was chaotic. There was no difference of gastroscopic findings by family adaptability and cohesion scale and family type.

Conclusion : There were no relation between the family cohesion and adaptability and the gastroscopic findings. And there was no significant relations between the family function index and common clinical symptoms, too. Only between the patients age and gastroscopic findings was significant (P<0.05)

Background
: Acute epiglottitis is an emergency condition developing primarily in children which cause acute upper airway obstruction but rarely in adults. Numerous reports in the literature reveal that a majority of cases occur mainly in young children under six years of age, however, the recent reports about acute epiglottitis in adults are increasing.

Methods : We represent 32 cases of acute epiglottitis in adults with review of literatures in terms of clinical feature, diagnosis and management. We also discuss the differences between acute epiglottitis in adults and in children.

Results : The results are as follows. The age of patients were ranging from 17 to 72 with highest incidence at 5th decade and mean age was 43 years old and the ratio of M:F is 6:1. Dysphasia (66%) is more frequent symptom than respiratory difficulty (53%). For the diagnosis, clinical symptoms, indirect laryngoscopy and soft tissue X-ray of neck, CT or MRI were used. In pharyngeal smears and cultures, 3 cases of Staphylococcus and 2 cases of Pseudomonas aeruginosa were detected and in blood cultures, no pathogenic organism was detected. The main treatment was conservative treatment except 4 cases.

Conclusion : There was significant difference in acute epiglottitis between children and adults. Early diagnosis and rapid conservative treatment is very important in clinical practice without unnecessary tracheotomy.