Background
: Hypercholesterolemia is a well known risk factor of coronary heart disease. In Korea, coronary heart disease is increasing according to the change of dietary patterns and other causes such as economic growth. In order to make more appropriated our therapeutic guidelines and to analyse about characteristics of patients with hyperlipidemia, we carried out this study.

Methods : We examed therapeutic compliance and results according to therapeutic methods and change of serum lipid levels after termination of treatment to 58 hyperlipidemias who were diagnosed and treated due to hyperlipidemia. This 58 hyperlipidemic patients were visited family medicine out-patient department at Seoul Christian General Hospital during period from Sep.1.1991 to Aug. 31. 1992.

Results : Among patients with hyperlipidemia, only 29.3% terminated their treatment, and only 58.6% had follow-up checks. The incidence of termination of treatment was higher in the group using lipid-lowing medication than in groups not using lipid-lowing medication than in groups not rsing lipid-lowing drugs. The duration of treatment was shorter in the group using lipid-lowing medication than in groups not using lipid-lowing drugs. After treatment, mean serum levels of total cholesterol and triglyceride decreased regardless of therpeutic methods. Mean serum levels of total cholesterol and triglyceride after termination of treatment increased, and the increase in total cholesterol level was statistically significant.

Conclusion : The compliance and self recognition of hyperlipidemic patients about their disease were very low and life styles and dietary patterns were not maintained after termination of the treatment. Therefore, it is necessary to educate and propagate our people about the significances of complications caused by hyperlipidemia at National Health Provoking level, because it may cause significant public health problems.

Background
: Nicotine dependency has been known as an important discouraging factor for the most smokers who have already tried to quit smoking. We would like to find out factors affecting cessation of smoking by analyzing symptoms and signs of nicotine withdrawal and adverse effects of transdermal nicotine therapy(nicotine patch) when nicotine addictors try to stop smoking.

Methods : The records of 69 patients who were diagnosed as nicotine dependency by DSM-Ⅲ-R and were administered with transdermal nicotine patch at Nicotine Clinic of Yonsei Medical Center from March 1, 1992 to August 31, 1992.

Results : Unsuccessful quitters reported more withdrawal symptoms and signs and more adverse effect of nicotine patch than successful quitters as the follow-up period become longer, but the intensity of withdrawal symptoms and adverse effects of nicotine patch did not relate to the follow-up period : Unsuccessful quitters had more severe symptoms and adverse effects than sucessful quitters.

Conclusion : The severity of nicotine withdrawal symptoms and adverse effects of nicotine patch would influence the successful rates for cessation of smoking. As withdrawal symptoms and signs and adverse effects of nicotine patch become more severe, the failure of cessation of smoking would be more expected.

Background
: As a dramatic shift is occurring the demographics of Korean society, especially in the proportion of individuals over the age 65, there is a great concern to the disease commonly developed in the aged including pneumonia. Pneumonia is a major cause of death for the elderly. Clinical symptoms and signs of pneumonia in the elderly are often muted. Timely, accurate diagnosis and therapy depend on recognition of atypical manifestations of pneumonia in the elderly. The goals of this study were to describe atypical clinical manifestation of pneumonia in the elderly and to analyze the predictors associated with mortality.

Methods : The records were retrospectively reviewed of randomized patients older than 65 years with a diagnosis of pneumonia who were admitted to Yonsei Medical Center from January, 1990 to June, 1992 and were compared to the those of younger-aged groups with pneumonia who were admitted to Yonsei Medical Center at the same period of time.

Results : In the elderly, pneumonia is associated with considerable mortality, 28.3%. More atypical clinical symptoms and signs were presented in the elderly, comparing to those of the younger control group. Cough, sputum and fever were less frequently presented in the elderly. Patients with preexisting chronic lung disease, tachypnea, tachycardia or without temperature elevation were associated with mortality. The most commonly identified pathogen was gram-negative bacilli and there were no difference of chest X-ray pattern and therapeutic regimens between the elderly and control groups.

Conclusion : Pneumonia in the elderly is a serious condition with high mortality. Because of atypical and subtle clinical manifestations of pneumonia in the elderly, a high index of suspicion will induce the physician to diagnose and treat pneumonia timely and properly.

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
: 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
: Previous numerous studies proved the reliability and validity of family APGAR score and FACES Ⅲ which are often used in family function test. We performed this study to analyze the correlation between family APGAR score and FACES Ⅲ.

Methods : This study based on the questionnaires answered by 204 unmarried productive part women who were engaged in a manufacturing plant at Ku-mi from August 1st to August 31th, 1992. The results were processed with SPSS statistical package and analysed by mantel-Haenzel trend test.

Results : Male were 87(42.6%) and female were 117(57.4%) and mean age was 23.26(±3.13) years, most of them(198(97.0%)) were high school graduated. There was a significant correlation between APGAR score and family types of FACES Ⅲ (P<0.01). There was a significant correlation between APGAR score and Cohesion of FACES Ⅲ (P<0.001). There was no significant correlation between APGAR socre and Adaptability of FACES Ⅲ.

Conclusion : From this tudy, we found that family APGAR score and FACES Ⅲ has close correlation each other, and this correlation depended on the Cohesion of FACES Ⅲ.

Background
: The medical research is important to physicians. It is difficult for family physicians to set up research subject because family practice disciplines are wide. I thought that citation analysis of The Journal of the Korean Academy of Family Medicine was important to search for the family practice disciplines.

Methods : The citation analysis of the research articles, published in The Journal of the Korean Academy of Family Medicine over the 11 years, from November 1980(the first number of journal) through December 1991.

Results : A total of 5,316 citation count of references was found over the 11 year period publication of The Journal of the Korean Academy of Family medicine from 245 different journal source.
The average number of the citations per research article is 21.7. The average number of domestic citations per research article is 7.4. The average number of foreign citations per research article is 14.4. The average number of monograph and textbook citations per research article is 4.7. The average number of journal citations per research article is 16.8. The average number of rest citations per research article is 0.1. The most frequent cited journal was The Journal of the Korean Academy of Family Medicine(321). The average of The Journal of the Korean Academy of Family Medicine per research article is 1.3. The next frequently cited journals were as follows. The Journal of Family Practice(297), The journal of the American Medical Association(152), The Koreaan Journal of Internal Medicine(140), The New England Journal of Medicine(121), Journal of Korean Neuropsychiatric Association(114), The Lancet(84), British Medical Journal(81), Jurnal Korean Medical Association(80), Journal of Korean Pediatric Association(73), Korean Journal of Obstetrics and Gynecology(62).
The cumulative proportion of all citation from the most 10 frequently cited journal were 27%.

Conclusion : The results from citation analysis of The Journal of the Korean Academy of Family medicine as follows : Domestic citations are more frequently cited than foregin citations, Journal citations are more cited than monograph and textbook citations. The most frequently cited reference journal is The Journal of the Korean Academy of Family Medicine. But the proportion of the average number of the Journal of the Korean Academy of Family medicine per reserch article(1.3) to the average number of cited journal per reserch article(16.8) is low. When we can classify the major disciplines in family medicine. They can be classified into Family practice, General multidisplinary, Internal medicine, Neuropsychiatry, Obstetrics and Gynecology, Pediatrics, Surgery, Medical education, Epidemiology, Public health and preventive medicine. The disciplines in family medicine has not been determined yet. The major disciplines in family medicine are in process of research so that the disciplines in family medicine can develope by active research in fresh disciplines.