Background
: A health questionnaire and feedback system was developed to promote clinical preventive services for people of age 18 or older. This system was designed to recognize common but significant health problems and feedback their risk factors.

Methods : The health questionnaire consists of about 300 items which cover 14 systems and 34 organs/diseases. Certain combinations of the items lead to the three level assessment. This was done through a computer program. Each person who filled up the questionnaire receives those assessments, their interpretations and appropriate management plans via mail. To develop the questionnaire, 26 specialists and family physicians were consulted, and a pilot test on nonhealth persons was performed. The computer assessment algorithm and feedback were also reviewed by 6 specialists. he accuracy of the computer-genarated feedback was evaluated through comparison of the feedback and the physicians' clinical impressions on 527 patients who visited the family practice department in a university hospital.

Results : The study subjects consisted of 227 men and 300 women, and their average age was 40.2 years with the youngest of 18 and oldest of 74. It took 23.4 minutes in average to answer the questionnaire. the questionnaire by the organ system showed moderage reliability (Cronbach's alpha=0.493-0.854), if the organ systems with less than 10 items were excluded. the positive and negative predictive values for 29 organs/diseases were 73.6% and 40.2% respectively. The digestive organs showed the highest positive predictive valuse of more than 90% and the endocrine system and skin showed the lowest ones of less than 60%.

Conclusion : The developed questionnaire and feedback system seems to contribute to the clinical preventive services which is insufficient in Korea.

Background
: Acquired immunodeficiency syndrome(AIDS), a serious health problem worldwide today, is already so common a health problem in the western countries that it is a primary care disease, not a tertiary care disease. Especially as there is ano effective treatment established nor has any vaccine been developed, prevention has been the best treatment till now and controlling the transmission routes is the most important preventive method. Therefore, we conducted a survey on how knowlegeable Korean university freshmen are on AIDS, what kind of attitude they have toward AIDS and how interested they are in AIDS. This survey was aimed at providing the basic data for school health education and AIDS prevention programs geared to stop the disease from spreading.

Methods : From December 1992 to February 1993, we questioned 6,521 freshmen of 5 universities in Seoul who were assigned to take physical examinations in Kyung Hee Medical Center and analyzed 6,035 responses, excluding cases with insufficient answers.

Results : Overall the respondents have accurate information on AIDS. 20~40% of the respondents gave incorrect answers to the following questions : "AIDS is a medical condition which your body can't fight off", "All homosexual men and women are likely to contract AIDS", "AIDS can be caused by insect bites such as mosquito bites", "You can get AIDS by using AIDS patient's personal belongings", "You can get AIDS from eating food prepared by a person who has AIDS", "AIDS can be caused by the same virus that causes sexually transmitted diseases","AIDS can be cured if treated early","A new vaccine has recently been developed for the prevention of AIDS", "Who declared December 1st as 'World AIDS Day'".

Conclusion : The respondents have an adequate amount of knowledge on AIDS but some of the information they have is not accurate. As it is shown by the fact that many of the respondents are not aware of the existence of a law for AIDS prevention in Korea, there is not sufficient AIDS information available, We conclude that proper education is needed to provide the accurate information on the disease for the public. In addition, more study on adolescent's sexual activities, knowledge on AIDS, atttude toward it should be done.

Background
: Osteoporosis is the most common metabolic disease of the bone, and thought as public health problem due to its high prevalence and cost. Family physician as primary care physician is much interested in the osteoporosis. so we studied the rate of osteoporosis, severity and related risk factors of osteoporosis from high risk postmenopause women, in order to be helped in early diagnosis, treatment and prevention of osteoporosis.

Methods : Among 706 patients who have taken Bone Mineral Density examination(DEXA) from Nov. 11, 1992, to Jul. 31, 1993 at Dong San Medical Center, we selected 102 natural postmenopause women who were not related to 2nd osteoporosis. The data was gathered from the BMD examination, qustionnaire and chart review. these data were analyzed using SAS/PC stastistic program.

Results : The mean age is 57.7 years and postmenopause age is 47.6 years. Osteoporosis was defined when BMD of patient was below 90% of age-matched control value. Number of osteoporosis and normal group is 55 and 47, respectively. the rate of osteoporosis was 53.9%. The statistically significant difference was revealed between two groups in mean age, postmenopause age, duration of menstruation, duration after menopause, oral pill history, kyphosis and fracture history. In the multiple regression of risk factors to osteoporosis, height and postmenopause age had significant relation to the osteoporosis, and weight and Body Mass Index had trended to osteoporosis.

Conclusion : Family physician should consider there risk factors of the osteoporosis when postmenopause women visit. We think that the more precise study for risk factors to osteoporosis is essential.

Background
: Recently, general health examination is performed in rural area as well as urban area. Many persons recognize that early detection & protection of diseases are more important than treatment after disease occurrence and then many office workers receive general health examination. Our study was done to find the difference between health problems of rural & urban areas.

Methods : We compared each items of results of general health examination from June 1, 1993 to August 31, 1993 between 132 men who received general health examination in Dongsan medical center and reside in Taegu city and 145 men who received general health examination in Andong General hospital and reside in Kyeung-Book province.

Results : 1. Abnormal findings of chest X-ray(urban 5.3%, rural : 15.9%), anemia(urban : 1.5%, rural 9.7%), decreased liver function(SGOT urban ; 4.5%, rural ; 11.0% and SGPT urban : 14.4%, rural ; 29.7%) were statistically different between two areas.
2. Hypercholesterolemia(above 240mg% urban ; 22.7%, rural : 11.1%), abnormal ECG findings(urban ; 18.9%, rural ; 6.9%), abnormal fasting blood sugar level(110~139mg% urban ; 21.2%h, rural ; 13.1% and above 140mg% urban ; 3.8%, rural ; 2.8%) were statistically different between two areas.

Conclusion : We have a conclusion that family physician must recognize the results of health problems between urban and rural areas for good primary practice in each area.

Background
: Physical activity is highly associated with health, especiall reduces the risk coronary heart diseases and strengthens cardiovascular system, and then reduces morbidity and mortality. One of the most reliable and valid measures of physical activity is direct observation but it is not practical due to the most costly and burdensome. There this study compares two methods, Stanford 7-day Physical activity Recall questionnaire and electronic motion sensor monitor, and evaluates usefulness of these two methods in the field of primary care.

Methods : Fifty-one young male-adults in the second and third decades were recruited, 11 from medical school students, 15 from college students and 25 from residents and interns of university hospital doctors. Each subject was required to complete the Stanford 7-day Physical Activity Recall questionnaire and wear electronic motion sensor one day a week. Two weeks later, the second test was perfomed as the same way.

Results : In questionnaire. total physical activity was classified as sleep, light, moderate, hard and very hard activities. Mean hours spent for each activity for a week were 45.02±7.43, 99.11±13.19, 19.72±9.84, 2.90±3.04, 0.94±1.78 hours and reliabilities measured by test-retest were 0.72, 0.64, 0.70, 0.52, 0.55(p<0.01). The mean of daily energy expenditure was 42.74±5.14 kcal/kg/day and the reliability was 0.65(p<0.01).
Means of daily walking steps, distances and energy consumption for walking measured by electronic motion sensor were 13,195±5,036 steps, 6.58±2.55 km, 578.5±257.2 kcal and each correlation coefficient between the first and second tests was 0.65, 0.65, 0.75(p<0.01).
In comparison the energy expenditures resulted form Stanford questionnaire with the walking energy consumption from electronic motion sensor, the correaltion coefficients were -0.18(p=0.22) for sleep, -0.39(0=0.06) for light, 0.56(p<0.01) for moderate, -0.01(p=96) for hard, -0.02(p=0.91) for very hard activities in the first test. The moderate activity showed the highest correlation in both first and second tests(p<0.01).

Conclusion : The results of the Standard 7-day Physical Activity Recall questionnaire showed high reliabilities and relatively high correlation coefficieny with electronic motion sensor, especially in moderate activity, therefore it seems that the concurrent use of both methods for physical activity measure is more valuable than single use in the field of primary care and epidemiologic study.

Background
: The Goal of health Examination is to detect and treat diseases in its early stage for asymptomatic people. But there was the opinion that people who wanted comprehensive health check-up was not asymptomatic but diseased state had several symptoms. So we have performed the comprehensive health check-up which was appropriate for above opinion. It was given priority to history and physical examination. We analyzed the result of health check-up to get the basis of the appropriate health check-up model.

Methods : All subjects was 110 persons, who visited at the outpatient clinic of Department of Family Medicine in Dong-A University Hospital from May, 1991 to April, 1992 for the purpose of comprehensive health check-up. We permitted the interview time enough to take the history and physical examination. And the medical records of subjects were reviewed and analyzed.

Results : Total number of subjects was 110, of whom 63(57%) were male and 47(43%) were female. Among the age distribution, the most was the fifth decade. The most common chief complanints was fatigue, it was 20 persons(18.2%). 21 persons chose the health screening test by themselves, of whom 13 persons chose LFT & viral hepatitis markers. The numbers of symptoms per each person were as follows ; Four symptoms was the most frequent, it was 30 persons(27%). Asymptomatic adult was only 3 persons and nine and ten symptoms were in each one case. At past history, 35 persons(32%) were diagnosed as having diseases in other hospital, and the most frequent disease was hepatitis or other liver problems in 12 persons(34.3%). Among them, re-diagnosed patients were 30 persons. 15 persons were not performed the laboratory examination, so 95 persons were diagnosed. After this examination, total patients who were diagnosed as having diseases were 89case(93.7%). The most frequent diagnosed disease was clonorchiasis in 17 cases(17.9%) and the second was chronic hepatitis in 11 cases (11.6%). By classification of ICD-9, disease of digestive system was most frequent and it was 47cases(35%). The second was 18cases(13.2%) of infectious and parasitic diseases.

Conclusion : Most of people who wanted comprehensive health check-up had diseases with several symptoms. There were also many patients who were re-diagnosed in this examination and in actually, it was necessary not to re-diagnose but to manage continuously for them.

Background
: The breast cancer is the fifth common tumor in statistics in mortality rate. The aim of this study is to evaluate the diagnostic efficacy of mammography and ultrasonography to dectect the breast cancer.

Methods : This retrospective study was carried out in 266 subjects who visited Youngdong Servrance Hospital due to breast disorders from March, 1992 to July, 1993. They were confirmed by pathology and preoperative mammography and/or ultrasonography.

Results : Among the 266 cases, breast cancer were 66 cases(24.8%) and benign breast disorder were 200 cases(75.2%). The cases which performed mammography were 207 cases, and the cases which performed ultrasonography were 164 cases. Among total 266 cases, the cases which performed both mammography and ultrasonography were 176 cases.
Mean age was 45.03 years in breast cancer group but mean age was 38.73 years in benign disorder group(P<0.01). In breast cancer group, chief complaints on admission were palpable msss(90.3%), breast pain(7.6%), abnormal finding in periodic health examination(7.6%). But in benign disorder group, chief complaints were palpable mass(53.5%), abnormal finding in periodic health examination(21.5%), nipple discharge(8.5%) The efficacy of film mammography to detect breast cancer was as followed : sensitivity was 87.7%, specificity was 66.7% and positive predictive value was 54.8%. The efficacy of ultrasonography to detect breast cancer was as followed : sensitivity was 82.8%, specificity was 66.7% and positive predictive value was 45.2%.

Conclusion : Film mammography is useful for mass screening because of high sensitivity, and ultrasonography is useful as additional study to detect breast cancer.

Background
: All of us want good health. But many of us do not know how to be as healthy as possible. Health experts now describe lifestyle as one of the most important factors affecting health. In fact, it is estimated that as many as seven of the ten leading causes of death could be reduced through common-sense changes in liffestyle. This stydy was performed in order to help actively intervention of family physician by using healthstyle a self-test

Methods : The analysis and interpretation was done about healthstyle of the whole persons who first visited Family Practice of the Schoon Chun Hyang University Medical College from April, 1993 to July, 1993 via queationnaire.

Results : About total score of each healthstyle, 30.2% among men are the highest score at the Alcohol and Drugs, 85.0% among wemen, Smoking. 44.7% among men are the lowest score at the Smoking, 40.6% among wemen, Exercise/Fitness. Cases more that 0 score subtraction of real score from expected score among men were ranked Smoking. Alcohol and Drugs, Eating habits, Exercise/Fitness and among wemen, Eating Habits, Exercise/Fitness, Stress control. In compaing the subtraction of real score from expected score, among men, Smoking, Alcohol and Drugs had statistically significantly larger, among married persons, Exercise/Fitness, among unmarried persons, Smoking and among persons' income less than 99×10⁴won,Safety. In comparing the subtraction, current smoker had statiscally significantly larger at the Alcohol and Drugs, regular exercise, at the Stress control, havey drink more than 3 times a week, at the Smoking.

Conclusion : Among men, healthstyles about Smoking, Alcohol and Drugs, Eating Habits and Exercise/Fitness were considered better than real score and among wemen, Eating habits, Exercise/Fitness, Stress Control. About Smoking, men, unmarried, irreligious persons, curent smoker, heavy drink more that 3 times a week, about Alcohol and Drugs, men, irreligious persons. current smoker, about Eating Habits. irreligious persons, about Exercise/Fitness, married persons, about Stress Control, regular exercise, about Exercise/Fitness, married persons, about Stress Control, regular exercise, about Safety, persons' income less than 99×10⁴won have need for actively intervention of family physician taking charge of primary care.

Background
: Computer use in medicine is also incresing now in primary health care. Untill now, there has been no report on the clinical use of computer in family pracice in Korea.

Methods : Among 525 members of Korean Academy of Family Physicians woh are in primary practice in Seoul, 297 physicaian's office telephone numbers are on phone-directory. In August 1993, four-page questionnaires were sent to 297 physicians. To get higher response rate was 52%. To compensate low response rate, phone interview of 38 physician was done by random sampling of nonresponders.

Results : 79% of responders currently use computer in clinic, while 32% use computer personally. There were no differences between responders and nonresponders in sex, rate of computer use, but mean age of responders is lower than that of nonresponders(50.8±13.5 vs. 57.1±10.9). Among clinical usages of computer, billing is by far common(100%). Medical record retrieval systems anre used by 26.4%, Drug management by 14.6% of physicians with computers in their offices. Only one physician used complete electronic medical record.

Conclusion : Majority of family physicians in primary health care use computer in clinic. But the use is confined to a few areas. Among the variabels, age and personal computer use seem to be related to the number of arease used. Major obstacles to the medical computing are 'not acquainted with computer use', 'lack of standardization of programs'. So there are urgent needs for education of computing and standardization of programs.