Background
: Obesity level and fat distribution are thought to be the risk factors of hypertension, Diabetus Mellitus, and hyperlipideman. But diagnositc methods and criteria of obesity are various. In this study, the impact of obesity level and fat distribution to blood pressure,blood glucose, and serum lipids alipoproteins were evaluated, using new diagnostic method and criteria of obesity mixed with standard weight and body mass index(BMI), and waist-to-hip circumference ratio(WHR).

Methods : This study was carried out with 902 individuals who had no specific past history and no abnormal laboratory data in 1330 individuals who visited 'Soon Chun Hyng Human Dock Center' from May to June 1993. Subjects were checked sex, age, height, weight, waist circumferece, hip circumference, blood pressure, fasting blood sugar, oral glucose tolerance test after 1 hour, cholesterol, triglyceride, high density lipoprotein cholesterol, and low density liporotein cholesterol. Relationship of obesity level and fat distribution to blood pressure, blood glucose, and serum lipids and lipoproteins were evaluated after adjustment for age and BMI.

Results : Four groups by new diagnostic method and criteria of obesity were compared after adjustment for age. Blood pressure, blood sugar, and serum lipids and lipoproteins were significantly different in men, but only diastolic blood pressure and high density lipoprotein cholesterol were significantly different in women. Two groups by WHR were compared after adjustment for age and BMI. Fasting blood sugar, cholesterol, triglyceride, and high density lipoprotein cholesterol were significantly different in men, but only blood pressure was significantly different in women.

Conclusion : New diagnostic method of obesity is valuable for that mixed BMI and Doqquei's obesity index(standard weight÷22X(height(m))²) that is relatively normal distribution, and similar with BMI in distribution. Although somewhat different results were shown in men and women group, obesity level and fat distribution are thought to be the risk factors of hypertension, Diabetus Mellitus, and hyperlipidemia.

Background
: Alcoholism developed by the interaction of biologic, psychologic, sociologic factors and family structure etc. Alcohlics influence of lives of their families and emotional status of their family members harmfully. Therefore family functions of alcoholics are dysfunctional states more easily. For the understanding of alcoholics' family and the proper family therapy of alcoholic family we evaluate factors that correlated with functions of alcoholics and family functions of thier families.

Methods : There were 32 subject groups, each group contains 1 patient and 1 person among family members. The control group are consisted of 32 nonalcoholic persons. Questionnaire was consisted of sociodemographic data, Family APGAR, FACES III, SCR-90R(for evaluation of psychiatric symptom) and MAST(Michigan Alcoholism Screening Test). The results were analyzed by descriptive, comparative and correlative analysis.

Results : Mean age of the patients, their family members and control were 40.9, 38.9 and 32.7 years of age respectively. Other demographic factors showed no statistically significant differences between alcoholic group and control group. The APGAR scores of alcoholics, their family members and controls were 4.5±2.1, 4.3±2.3 and 6.6±2.0 respectively(P<0.01). In alcoholics, praranoid scale was highest among psychiatric symptoms and psychotism, depression, interpersonal sensitivity, anxiety, obscessive-compulsive scale were higher than control(P<0.01). In alcoholics' families, family obscessive-compulsive(P<0.01), depression, hostility, psychotism scale were higher than that of controls(P<0.05). There were significant correlations of psychiatric symptoms between alcoholics and their family members in depression, anxiety, somatization scale(P<0.05). In cases of another alcohol abuser were in family, Family APGAR score, Adaptability and Growth scale of Family APGAR, FACES III Adaptability score were significantly low. In cases of higher MAST scores(above 30), growth and affection of Family APGAR and FACES III Cohesion were significantly were significantly lower than that of lower MAST scores(less than 30), obscessive-compulsive influence of Resolve score of Family APGAR of alcoholics. Some psychiatric symptoms influence on Family APGAR and FACES III of alcoholics families. Obscessive-compulsive influence on Family APGAR. Phobic anxiety influence on Resolve of Family APGAR. Obscessive-compulive, phobic anxiety influence of Growth of APGAR. Somatization, interpersonal sensitivity, depression influence on FACES III Adaptability.

Conclusion : We conclude that family function scores of alcoholics and their family members were lower than that of controls. Alcoholics and thier family members showed tendency of increasing the incidences of phychiatric symptoms. Severity of alcoholic, alcohol abuser in family, psychiatric symptoms influence on family function. Therefore in family therapy, we should evaluate family function score of all family members and should consider the severity of alcoholic, alcohol abuser in family, importance and severity of psychiatric symptoms of alcoholics and their family members.

Background
: Recently, the frequency of the diseases in the geriatrics is on the increase gradually as increasing of the aged population. The acute abdomen which incurs danger if an adequate management is not performend under the exact diagnosis in the geriatric patients is common. This study analyze the factors influencing on postoperative complications and mortality for decreasing the rate of them.

Methods : we analyzed age and sex distribution, disease distribution, coexisting diseases, preoperative phyical status, anesthesia time, it's complication and mortality, complication distribution and causes of death of 105 cases of the geriatric patients undergone emergency operation for acute abdomen on from Jan. 1991 to Aug. 1993 at Seoul Christian General Hospital.

Results : The sex ratio between male and female was 1:1.2, the range of age was from 65 to 87 years. 70-74 years was most common(31.4%) among the classifications of the age. In distrubutions of diseases, acute appendicitis was the commonest(35.2%), hepatobiliary disease was 28.6%, and upper GI tract disease was 18.1%. The coexisting diseases were found in 68.8%, of patients and cardiovascular disease was the commonest(28.2%). In preperative physical status, Class II was the commonest(40.0%) and Class V was 2.9%. In anesthesia time, the number of cases between one and two hours was 48 cases and was the commonest(45.7%) and that below 2 hours was 59 cases(56.2%). Postoperative complications were found in 31.4% of patients, pulmonary complication was the commonest, and the next was intestinal obstruction. The mortality rate was 11.4% and multiple organ failure was the most common in the cause of death, the others were sepsis and acute respiratory failure etc.
In the analysis of factors affecting complication and mortality, the age was not related to the complication and mortality. The complication was the highest in patients with colorectal disease and the mortality was the highest in patients with strangulated hernia. There was a large number of complications in the patients who have had coexisting diseases and also the mortality rate was higher among them, but there were no significant differences statistically. The higher the Class, the higher the complication and the mortality rate on the preoperative physical status. There were more frequent complications in the anesthesia time above 2 hours. The mortality rate was higher in the anesthesia time below 2 hours but there was no significant differences statistically.

Conclusion : Consequently, postoperative complication and mortality in the geriatric patients were not related to age, but associated with primary diseases, coexisting diseases, preoperatice physical status and anesthesia time. Therefore it is thought hat postoperative complication and mortality will be decreased, if primary physicians make every efforts to diagnose early primary disease, concern about the existence of coexisting disease, improve the preoperative physical status, and decrease the anesthesia time in management of geriatric patients.

Background
: Spinal cord injured patients are increased due to occupational and traffic accidents. To give them a comprehensive and continuous medical service, the authors investigated the factors that could influence the psychopathology and functional level and the relationship of psychopathology and functional level.

Methods : 56 spinal cord injured patients ranging in age from 18 to 57 years who were under treatmtnet at rehabilitation centers were completed the study.

Results : The depression scale of the patients who got religion was significantly lower than that of the patients who did not. Somatization scale was higher in patients of duration of more than 1 year. Other demographic factors did not influence the psychopathology. Barthel index was influenced by the level of injury and the duration, but there was no relation between the psychopathology and Barthel score.

Conclusion : The authors expected that psychopthology could influence the functional level of spinal cord injured patients, but the results we got from this study was not. There was no significant relation between the level of injured cord and the phychopathology.

Background
: What changes are developed by insufficinet nutritional intake or total fasting was considered as good clues for health maintenance of starving and treatment of overnutrition. But research into starvation can be problematic from ethical point of view. So, in most studies, animals or only a few volunteers were included as study subjects. This created difficulties in overcoming the limitations of animal experiments and too small sample size to generalize the study results.

Methods : Fasting was continued for a period of 5 days in 201 health people voluntarily from sociopolitical reason. During this time no food was eaten. But water and NaCl was allowed ad libitum. We, under thier agreement, observed changes in body mass, blood pressure, pulse rate, blood cell count, and blood chemistry. Using a self-administered questionnaire, we checked any symptoms which were aggravated by or newly developed during fasting.

Results : The most commonly checked symptom was 'weakness in hands and feet', followed by 'difficulty in going upstaris and downstairs', 'dizziness', and 'foul odor from the mouth'. Total body weight loss was 2.7kg on the average. Systolic and diastolic blood pressure decreased significantly only in men. WBC count, phosphorus, BUN, glucose, and amylase decreased significantly. Platelet count, creatinine kinase, S-GOT, S-GPT, uric aicd, cholesterol, and triglyceride increased significantly. Direct bilitubin increased in all people, but statistical significance was found only in men. Total calcium level increased in all people but statistical significance was found only in women.

Conclusion : 5-day fasitng resulted in more weight loss than expected from the compensation mechanism for calory deficiency. And fasting produced not only aggravation and new development of symptoms, but also changes in blood pressure, blood cell count, and blood chemistry.

Background
: Aseptic meningitis is a common infectious disease in pediatric age. Etiologic agents are mainly enterovirus group. Arbovirus and mumps virus, etc. Diagnosis was confirmed by culture and separation of virus, but is dependent on physical examination and CSF finding.

Methods : This study was analyzed in 245 cases chart who had admitted for aseptic meningitis from May 1994 to August 1994 at Nam Won Medical Center. The method was carried out physical examination, clinical manifestation, lab finding response to treatment, prognosis.

Results : The ratio of male of female was 2.3:1, mean age was 5.6 years old. Clinical manifestations were fever(94.2%), headache(77.9%), neck stiffness(62.4%), throat injection(53.4%), Kernig sign(45.6%), anorexia(32.6%), abdominal pain(21.6%), cough(15.1%), nausea(4.4%), convulsion(2.4%). Mean febrile period was 3.4days. Leukocytosis was reported in 123 cases and ESR elevation was reported in 154 cases on CBC. On CSF examination, mean WBC counts were 502/mm³, mean protein level was 33.9mg/dl. Mean glucose level was 61.8mg/dl. Mean admission period was 9.2days.

Conclusion : All patients who had admitted for aseptic meningitis, were discharged without complication and sequela.

Background
: It is important to find out the risk factor for hypertension because the removal of risk factors prevent the occurrence of disease. Recently, there are syndrom X that is the complex of obesity,diabetes, blood lipid abnormality and artherosclosis combined hypertension. The study was conducted to evaluate the relative risk of hypertension for overwight, hyperglycemia, hypercholesterolemia.

Methods : In the data of 21,912 male and 13,805 female over the age of 20 who were taken the multiphasic health examination from 1988 to 1992 at Kangnam St. Mary's Hospital, we analysed age, systolic and diastolic blood pressure, body mass index, fasting blood sugar and blood cholesterol by SAS package program.

Results : The odds ratio of hypertension for overwight was about 5 in male and female below the age of 40, they were 2.43 and 3.11 in male and female over the age of 40. For hyperglycemia the odds ratio was 6.45 in male below the age of 40, and they were 1.67 and 2.23 in male and female over the age of 40 respectively. For hypercholesterolemia the odds ratio were 2.32 in male below the age of 40, and 1.31 and 2.28 in male and female over the age of 40 respectively. In male and female aged over 40 with normal body weight the odds ratio of hypertension for hyperglycemia were 2.15 and 2.94 respectively.

Conclusion : Overweight, hyperglycemia, hypercholesterolemia were confirmed as significant risk factors increasing the prevalence of hypertension by estimating the relative risk.

Background
: The recent change of the doctor-patient relationship and the recent emphasis on the patient as consumer has led to a growing interest in satisfaction survey. The results of previous studies on the relationship between patient satisfaction and specific interviewing behaviors have been difficult to generalize. But several researches have evaluated how physician behavior during medical visits affects patients outcome such as satisfaction. This study examines the relationship between selected interview characteristics, particularly physician's verbal behaviors, and levels of patient satisfaction in Korea.

Methods : 56 initial patient interviews by 3 family physicians at university-based family practice clinic were videotaped and rated using Davis Observation Code(DOC). Before seeing their physicians, patients completed a previsit questionnaire to determine their general level of satisfaction with health care. And postvisit questionnaires were administered to patients for measuring of patient satisfaction(visit-specific satisfaction).

Results : A number of significant relationship were between various dimensions of patient satisfaction and physician's specific interviewing behaviors. Results of correlational analysis indicate that higher patient satisfaction was associated with patient question(P<0.05), evaluation feedback(P<0.05), smoking behavior counseling(P<0.05), and greater interview length(P<0.05). There was negative relationship with waiting time for interview but not significant. The humaneness, quality and general subscales of visit-specific satisfaction were also positively related to patinet question, evaluation feedback. A multiple regression entering physician behaviors as variables showed that 11% of the variability in total patient satisfaction was explained by patient question(R²=0.01, P<0.05).

Conclusion : The findings suggest that patient question(by DOC) is the most powerful predictor of patient satisfaction. And patients are also satisfied with evaluation feedback. Implications of the results are discussed as well as methodological issue relating to further research. A reliable and valid questionnaire should be developed that can be used to assist faculty in assessing residents' skills from the patients' perspective in Korea.