Background
: Cervix cancer is the most common cancer in women. The incidence and the number of deaths from cervical cancer were reduced by the effective screening test-Pap smear. Therefore we carried out this study to determine the most effective way for increasing the rate of cervical cancer screening.

Methods : We tried four compliance enhancing intervention strategies (group I -reminder postcard/group Ⅱ-reminder phone call/group Ⅲ-postcard and education material/group Ⅳ-postcard and education material and phone) to 224 female patients who visited previously family medical center, and compliance predictors were examined by questionnaires.

Results : Total compliance rate was 35.8% and compliance rates of each group were 32.5%, 34.9%, 31.8%, 44.7%. Difference among the four groups was not statistically significant (X²=1.7087 P=0.6084). The likelihood of obtaining the cervical cancer screening test were linked to the number of Pap smears the previous years, education level, the number of visit to hospital the previous year, family history of cervical cancer(P<0.05).

Conclusion : Postcard reminder is the simple and cost-effective measure. To increase the compliance of cervix cancer screening test, primary care physicians should take more active role in extending cervical screening coverage.

Background
: The functional gastrointestinal disorder is frequently seen in the general population by primary care physicians and family physicians in Korea. The patients who complain functional dyspepsia have been diagnosed frequently depression anxiety, hysteria, and alcoholism. The aim of this study is to evaluate the pattern of depression in the functional dyspepsia patients by self rating depression scale, 21 items of Beck Depression Inventory(BDI).

Methods : A patient who has multiple (more than two) symptoms of upper GI problem-epigastric pain, epigastric fullness, belching, anorexia nausea, vomiting, early satiety-was diagnosed functional dyspepsia and included in the case group people who have no symptoms were included in the control group. they are matched by sex and age.

Results : The laboratory findings of blood chemistry and ultrasonographic findings of gall bladder were normal in both two groups. The pattern of depression is evaluated with BDI and cut-off point of the depression was determined as score of 10, 13,17, and 21. The cut-off point of depression scale was compared and there was significant difference between two groups. The mean score of BDI scale in man and woman showed significant difference in both groups. There was significant difference in frequency of depression is female of 5th decade and 7th decade when the cut-off point was 10, but only in 6th decade when the cut-off point was 13.

Conclusion : The functional dyspepsia group showed a higher prevalence of depression than control group, and it was prominent in the 5th and 7th decade in female.

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
: Arteriosclerosis is clinically main cause of coronary heart disease, no traumatic sudden death and Cerebrovascular disease. In our country, the diseases related arteriosclerosis are increasing according to the change of dietary patterns and other causes such as economy growth.

Methods : We measured height, weight, BP, FBS, fasting cholesterol, and fasting TG of the 6214 persons participated in Employee Periodic Health examinations and observed prevalence and relative risk of each risk factors-obesity , hypertension, DM, and hypercholesterolemia.

Results : The prevalence of obesity showed 0.9% in males, 1.0% in females, and 0.9% in all. The prevalence of hypertension showed 10.9% in males, 6.2% in females, and 10.8% in all.
The prevalence of hypertension and hypercholesterolemia were significantly higher in males. The prevalence of hypertension and DM were higher in rural area among metropolitan, small & medium cities and rural area : The prevalence of hypercholesterolemia was higher in small & medium cities. but it was not significant statistically.
The prevalence of hypertension, DM and hypercholesterolemia, except obesity was increased as the age increased. The relative risk of hypertension was 1.8 in DM, and it was 2.0 in obesity BMI≤30kg/m²). The relative risk of DM was 1.9 in obesity, hypertension, hypertriglyceridemia and among those aged over 45 years, the relative risk in all age groups, was greater than those aged below 45 years. The relative risk of hypercholesterolemia for obesity was 2.4 that for the non-obesity, and among aged over 45 years, the relative risk in all age groups, was greater than those aged below 45 years. The relative risk of hypertriglyceridemia for obesity was 1.8 that for the non-obesity, and among aged below 45 years, the relative risk in all age group, was greater than that aged over 45 years.

Conclusion : The relative risk of the risk factors of arteriosclerosis were different to the age. The obesity showed more higher relative risk than other risk factors. Because each risk factors affect on another, it is a task ot make clear the mutual connection among each factors through further studies.
physicians should take more active role in extending cervical screening corverage.

Background
: In recent years, the incidences of atherosclerosis is increased among Korean because of socioeconomic and diet change. And it is known that many biochemical markers for atherosclerosis including serum total cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol are exist. Among these markers, serum total cholesterol is most basal parameter for screening the risk of atherosclerotic coronary heart disease. In order to determine the cut off value of serum total cholesterol for risk of atherosclerosis in Korean people, we carried out this study.

Methods : Data were gathered from 679 adults over 20yrs-old who were evaluated for general check-up during period from June 1990 to May 1991. Except 383 abnormal groups on physical examination and laboratory study, 296 healthy groups was analyzed and evaluated. Serum total cholesterol, LDL-cholesterol, triglyceride level was distributed with age, and serum total cholesterol was utilized for cut-off point.

Results : The serum total cholesterol and LDL-cholesterol were increased with age in both sex, and triglyceride was increased with age in woman but in men. There were no relation-ship between HDL-cholesterol and age. There was no significant difference of serum total cholesterol by sex. The cut-off point of total cholesterol for moderate risk was 186mg/dl at 3rd decade, 202mg/dl at 4th decade, and 205mg/dl at 5th decade, and 223mg/dl at 6th decade, and 249mg/dl at 7th decade. Also the cut-off points of total cholesterol for high risk were 202mg/dl at 3rd decade, 223mg/dl at 4th decade, 229mg/dl at 5th decade, 236mg/dl at 6th decade and 260mg/dl at 7th decade.

Conclusion : Results of this study may be not sufficient to apply on all Korean adults because this study group was limited and small. But we tried for cut-off value of serum total cholesterol for risk group of atherosclerosis. And, further study and effort for reducing the risk of atherosclerosis should be evaluated.

The periodic health examination is an essential part in Family Medicine for health promotion and disease prevention. The patients' compliance for the health exams is required basically for the efficacy of those health exams. 150 patients were selected randomly among 1962 patients who visited an urban health exam center from May to August in 1990 to investigate the patients' thoughts about health screening examinations. 136 patients responded to 3-paged structured questionnaire in the half of which the typical health exam costs were noticed for each health exam item. It was suggested that the patients should select the health exam items among the 10 laboratory procedure items. (Pap smear exam was excluded for men.)
58% of those patients had got health examinations at least once before that time. New problems which were previously unknown were found in 14% of them by health examinations. Listing typical health exam costs did not alter the selection rates of the patients. Who paid health examination costs for them did not also alter the selection rates of the patients. Patients wanted to get health exams more frequently than they were generally recommended.

Background
: Paraquat has been widely used as an herbicide in Korea since 1970. Ingestion of this drug results with high mortality rate(70%~90%), therefore we performed its clinical pathophysiologic and therapeutic analysis with review of other reports.

Methods : We experienced 21 patients with paraquat poisoning from May, 1989 until Dec, 1990 and analyzed this group into as follows : 1) sex ratio, age distribution, and ingestion amount 2) major clinical symptoms & signs, physical findings and laboratory findings 3) progress and prognostic factors 4) repeated intoxication(1 case).

Results : 1) Sex ratio was 1.5 : 1 with male predominance. In male the highest age distribution were in 3rd and 4th decades(69.2%) and in female, in 2nd and 6th decades(87.5%). 2) The major clinical symptoms and signs from admission to 1(67%), epigastric pain(43%), dyspnea(38%), oliguria(23%), and hypertension(10%). 3) The clinical progress were acute renal failure(8case), adult respiratory distress syndrome(5case) and multiple organ failure or undetermined(11case) 4) In spite of repeated intoxication twice at interval of 13 months 1 case has survived without complication.

Conclusion : Ingestion of Paraquat results severe toxic effects in multiple organs(gastrointestine, lung, kidney, adrenal, and CNS), and which is unknown mechanism of pathophysiology, reveled high mortality rate(76%) without active treatment until initial 24hours to 48hours.