Background
: This study was performed to examine the clinical usefulness of abdominal ultrasonography in health screen.

Methods : Medical records and health screen records of 405 cases without chief complaint which were visited at general health screening center of Dongsan medical certer during 4 month - period from may, 1993 to august, 1993 were analyzed.

Results : We experienced 77% of normal ultrasonographic finding and 33% of abnormal ultrasonographic finding in 405 cases examined. We reviewed the results of the most common abnormal ultrasonographic finding in order of each organs, which were detected fatty liver in 17% : gallstone in 4% : renal cyst in 1.7% : splenomegaly in 0.7%. The classification of abnormal ultrasonographic finding were fatty liver, chronic hepatocellular disease, gall stone, clonorchiasis, liver cyst and renal cyst in order of decreasing frequency.
Sensitivity of ultrasound study in clonorchiasis was 43% and positive predictive value was 43% but specificity was 98%.

Conclusion : These results suggest it is well worth employing sonograph for health screening purposes especially for early detecrion of fatty liver, chronic hepatocellular disease, clonorchiasis, gallbladder stone, renal cyst, renal stone and splenomegaly. And analysis aspect expense-effect are required.

Background
: Hepatitis B Vaccination plays an important role in national health, so it has spreaded out widely since 10 years ago. But we still face difficulties in getting information on actual condition of the vaccination due to not having enough research on the status of vaccination rate. Therefore this research mainly focused on the vaccination rate in general population and those who need vaccination.

Methods : We surveyed 4,939 people who had visited General Health Screening Center of Asan Medical Center. We compared their vaccination rate according to their sex, age, educational background and their occupations. And we compared the positive rate of HBsAg and HBsAb according to vaccination status. We surveyed vaccination rate of 3,656 people, who were the individuals excluding those who were not vaccinated for they knews they were positive in HBsAg or HBsAb.

Results : 37% of total number of persons have been vaccinated. Among them 38.5% were males and 34.7% were females. This showed higher vaccination rate among men compare to women. In terms of age, teens showed 57.1%, the highest vaccination rate. Twenties to fourties showed 34~41% and fifties to the older showed 30~34% of vaccination rate. Therefore vaccination rate decreased as the age increased. Regarding educational background vaccination rate was 45.7% for college graduates or higher educational level. High school level showed 29.2%. This revealed higher percentage of vaccination rate among people with better educational background compared to those with less education. In terms of occupation, adiministratives, professionals showed 47.1%, 43.2% of vaccination rate. Factory workers, labors showed 35.3% of vaccination rate. Farmers and fishers showed very low vaccination rate of 4.9%. People with family history of liver disease showed higher percentage of 39.3% than those without(36.7%). Positive rate of HBsAg was higher in those woh were not vaccinated 8.3% than vaccinated group 2.3%. Postive rate of HBsAb was higher in vaccinated group 84.8% than those who had no vaccintion 68.0%. 44.2% of those who need vaccination have been vaccinated. In this group, vaccination rates according to sex, age, educational background, theri occupations and family history of liver diseases and positive rate of HBsAg and HBsAb showed same patterns of the total group.

Conclusion : HBV's vaccination rate was 37%. It showed higher vaccination rate in male youngeter, the educated, professional and individuals having a family history of liver disease.

Background
: As a complication peripheral polyneuropathy is frequently observed in diabetic patients. Although it has been reported that the duration of diabetes and the status of diaberic control played critical roles in pathogenesis of peripheral polyneuropathy, nothing else was known previously. In this paper we investigate the possible relationship between peripheral polyeuropathy and smoking among the diabetic patients, consequently to study if smoking induces any significant effects on the pathogenesis of the peripheral polyenuopathy.

Methods : The one hundred and four patients showing the symptom of periheral polyneuropthy and the same number of patients without the symtpom were chose among 296 patients, after excluding seemingly irrelevant 88 patients, who were hospitalized in the Presbyterian Medial Center at Jeonju from 1992. 1.1 to 1993.7.31. Those selected patients were called up for a inquiry and their medial records were also looked up in order to obtain the relevant data for the current investigation. The obtained data were the age, sex, duration of diabetes dringking behavior, and amount of smoking. These were analyzed statistically by utilizing SAS.

Results : The mean age of the group with the symptom of peripheral polyneuropathy is 57.5 years and that of the group without any symptom is 58.6 years. There shows no difference in the sexual ratio between two groups. Also, observed is that the age of onset of diabetes is younger, the duration of diabetes is longer, and more patients are using insulin in the group without the symptom of peripheral polyneuropathy(P<0.05). compared to the group without the symptom. On the other hand, no difference is noticed between the groups in the fasting blood suqar and the amount of smoking. Neither is seen the diffence of the onset age and duration of diabetes, and the controlling method of the blood glucose between the smoker and nonsmoker group.

Conclusion : It is not observed any relevant association between the smoking and the symptom of the peripheral polyneuropathy among the diabetic patients.

Background
: It is known that smoking is harmful to humanbody and it brings about several diseases and it has risk of losing life. A high white blood cell count has been shown leukocyte toxicity even to a normal and it has been shown to exist in certain disease status, such as current infection, some malignancies and acute myocardial infarction. It was reported that it involved in the pathogenesis of diseases such as gout, emphysema, artherosclerosis and coronary heart disease. This study intends to show the relationship between smoking status and white blood cell count.

Methods : From May 1992 to July 1993, we had a questionnaire interview, phone interview and mail interview to over 35 year-old male who had visited the presbyterian Medical Center for their health screening. Among them, we studied 447 persons. Hypertension, diabetes, cardiovascular disease and hyperlipidemia were excluded. We made a distinction current smoker, ex-smoker, non-smoker from them according to smoking status. There was many variables according to age, education, economics, smoking status, the amounts of daily smoking, the duration of smoking, alcohol drinking, exercise status, diseases, height, weight, BMI and white blood cell counts. We made use of Chi-square test, ANOVA test and multiple regression analysis in order to make a statistical analysis.

Results : Current smokers were 250, ex-smokers were 24, non-smokers were 173. There was a positive association between smoking status and white blood cell count(P<0.05). Other associations were exercise status, alcohol drinking and education. Mean white blood cell counts according to smoking status were 6,472cells/mm³ in non-smokers, 6,979 cells/mm³, 7,258 cells/mm³ when they exercised for over 30 minutes everyday and exerciser's case, mean white blood cell counts were 6,544 cells/mm³. Also they were 7,228 cells/mm³ when they never exercised(P<0.05). There was a significant association between smoking status and a high white blood cell count though we controlled the exercise status(P<0.05). It was examined that the more the amounts of smoking incerased, the more white blood cell count inereased(p<0.05). It was examined that the more the amounts of smoking incerased, the more white blood cell count inereased(p<0.05).

Conclusion : There was a significant association between smoking status and a high white blood cell count. After we controlled the disturbance factor, the results were same. There was a dose-response relationship between the amounts of smoking and white blood cell count. Therefore we can conclude that smoking increase white blood cell count and it is a factor of strengthening leukocyte toxicity.

Background
: In recent years, the interest of people in health promotion and disease prevention is increased by virtue of economic growth. And the effort of promoting health, preventing and treating disease through food is added up too. In order to investigate the recognition about food which affects health and disease, we carried out this study.

Methods : We selected randomly the patients (group 1) who visited family medicine clinic of SNUH during period from August to September 1993 and one high school students family members(group 2) who are above 20 years old, for 4 paged questionnaire.

Results : Group 1 consists of 292 persons(male 36.0%, chronic patients 50%) and group 2 consists of 172 persons(male 35.5%, chronic patients 16.5%). Both groups answer that the food is the most important factor that affects health and disease. And they think that the best food for health is vegetable and the worst food is irritative one. They answer that the recommendation from the doctor is the most important factor that affects the diet therapy in chronic patients.

Conclusion : People regard food as the most important tool to promote health. The response on the importance of the food as the way of preventing and treating disease in positive in general. And it is proved that doctors play the most significant role of the diet therapy education for the chronic patients.

Background
: Menopausal syndrome is defined as a group of physical and psychological symptoms commonly experienced in the climacteric period due to estrogen deficiency, sociocultural factors and psychological ones. Although much of the literature on the menopause is dominated by physiological issues, there is now more interest in the sociocultural, psycological factors. So it is considerably important to understand variables which are attributing menopausal symptoms.

Methods : Data were obtained by a self-administered questionnaire including menopausal index by Kupperman et al, family APGAR, sociocultural factors, demographic characteristics and sexual ones. At this survey, the respondents were 340 menopausal women who visit health check-up center and family practice office.

Results : The variables positively associated with menopausal index included family APGAR, marital status, education, and exercise. But multivariate analysis showed that family APGAR and education were significantly associated with menopausal index.

Conclusion : This analysis focused on the relationship between menopausal syndrome and related variables. The variety of menopausal symptoms result from interaction between these many factors. So family physicians should have a comprehension about sociocultural and family factors in management of menopausal syndrome.

Background
: It is well known that breast-feeding is the best for infant feeding until 6 months. Breast-feeding tends to increase in 1970's, when breast-feeding was regarded as ideal method, but tends to decrease in 1980's worldwide. In Korea, breast-feeding tends to decrease since 1970. According to the past study about breast-feeding, the fact is that mothers don't know about the merit of breast-feeding that they have denied and education for continued breast-feeding, and that medical personnel don't always give great emphasis on breast-feeding. So this study is done to know whether Dr's recommendation and education on breast-feeding may influence on choice of feeding method.

Methods : The study subject was pregnant women who visited one OB & GYN clinic and bedelivered vaginally. Doctor recommend breast-feeding to them and offered education material about the merit and main point of breast-feeding. After 1 month of delivery, we examined feeding method by telephone immediately after delivery and 1 month later.

Results : Experimental group was 72 and control group was 71. Breast-feeding rate immediately after delivery was 56.3% in control, and 59.7% in experimental group, but there is no statistically significant difference. Breast feeding rate after 1 month was 38.0% in control, 41.7% in experimental group, and there is no statistically significant difference, too. The variable which influences choice of feeding method is feeding pattern determined before the delivery, those who determined to breast-feed before the delivery tend to feed breast milk(P<0.05). The variables which influence feeding method at 1 month are feeding method immediately after delivery and recommendation of close associates. Immediate breast feeders tend to breast feed continually until 1 month, and have been received less recommendation from close associats. Reasons of breast-feeding failure are insufficient amount of breast milk, refusal of babies, jaundice, and retracted nipple.

Conclusion : Dr's simple recommendation is not helpful for the choice of breast feeding. The variables which influences on feeding is feeding method before the delivery, which influences 1 month later.

Background
: Thirteen years ago, The Journal of the Korean Academy of Family Medicine was first published, through analysis of this journal, we can observe the staus of grouwth, development of further family medicine as a scientific and academic discipline.

Methods : An analysis was carried out by major content, type of paper, used statistical procedure and level of quality from 1981 to 1992 of The Journal of Family Practice(below JFP) and The Journal of the Korean Academy of Family Medicine(below JKAFM).

Results : Total 2357 papers of various type have been published. Among the 2375 papers, in JFP 1484, in JKAFM 891 papers published. Compared with both research type, 48.9% JFP used review article, 41.6% used cross-sectional design, 60.7% JKAFM used review article, 41.6% used cross-sectional design, 60.7% JKAFM used review article, 29.4% used cross-sectional design. Compared with the both journal content, biomedical article comprised the largest category in both journal(49.7% JFP, 79% JKAFM). level of quality was 5.31 in JFP, 5.72 in JKAFM(P<0.05). Most frequently used statistical procedure were Chi-square test and T-test in both journal.

Conclusion : Family practice specialty began with no research tradition, and work in this new area has required development of research skill method, and organized approach. This result reflect willingness of family practice for comprehensive, continuous care as scientific and academic discipline.

Background
: Today, increasing of aged population, because of longer average life-time and many uses of play and sport instrument for young have caused Colles fracture frequently. Primary physician often meet this sort of fracture and the primary physician should take very close examination such as causes, sex-distribution, treatment method, result, complication and prognosis. This study has aimed to find out treatment result, complication, and prognosis about long or short arm cast after U-shaped splint.

Methods : From Dec, 1991 to Spet, 1992, among the visited patients of Colles fracture at emergency room and orthopedics department in Seoul Christian Hosp. Myunmock-Dong. The 58 patients who simple extra-articular fracture treated by conservative treatment, primary physician applied manual reduction, U-shaped splint fixation and observed alignment by follow up X-ray after 1~2 weeks from trauma and then applied long or short arm cast.

Results : The age and sex distribution of those 58 patients shows that 2nd decade male and 6th decade female has higher incidence, and the causes of fracture were because of mainly daily life in 6th decade group and exercise in the 2nd decade group. In correlation between duration of immobilization and age, the younger the age, the shorter the duration of immobilization. The treatment result evaluated by the method of Gartland and Werley, shows that excellent was 30 cases(51.7%), good 21 cases(36.2%), fair 4 cases(6.9%), poor 3 cases(5.2%). This result mean that above good was 87.9%. The complications were finger stiffness in 3 cases, malunion in 2 cases, radiocarpal joint degenerative arthritis in 2 cases.

Conclusion : The simple extra-articular fracture of Colles fracturre can be expected good treatment result if stability of fracture is maintained in earlier state of trauma by U-shaped splint. So we, Family physician, must keep this treatments in minds that the good result can be obtained by applying this treatment immediately. As we have made a satisfactory study result by long or short arm cast after u-shaped splint, this will be a great help to treat the Colles fracturre in the future.

Background
: Falls and their consequences occur at all stages of life, but they occur much more commonly in old age and the elderly are more prone to injury themselves. Hip fracture is one of the most common and severe complications from falls. Furthermore, it is the leading cause of morbidity and mortality in the elderly. In this paper, we reviewed the charts and tried to find the characteristics of falls as a cause of hip fracture and risk factors in the elderly.

Methods : Charts were reviewed. The patients that admitted from January 1990 to July 1993 had all hip fractures and they were all above 65 years. The situations, place(mainly environmental factors), age, sex, BMI(body mass index), kinds of injury and existed intrinsic factors were reviewed.

Results : Total numbers were 202 cases, the fractures by falls were 161(79%). As ages increased, cases increased too. BMI was relatively low. (mean ; men 20.9, women 20.0) Femur neck fractures were developed relatively high than intertrochanteric fractures, environmental factors were involved in falls apparantly(94 cases, 62%). The places were restroom(22 cases), stairs(21 cases), roads(14 cases), room(12 cases), floors(0 cases), icy or snowy ways and so on. Intrinsic factors of falls were lower limb dysfunction(23 cases, 14.3%), visual disturbance(13 cases, 8.1%), past history of stroke(18 cases, 11.2%), Parkinson's disease(2 cases), and drugs including alcohol (2 cases). The number of intrinsic risk factors per one person was 0.44. Another risk factors were vertebral abnormalities and osteoporosis(11.3 cases, 6.8%) and chronic diseases(20 cases 12.4%).

Conclusion : Most of hip fractures were developed by falls. Falls were complex processes including environmental and intrinsic risk factors. Most of the elderly need the caution of falls and espesially the olds that have intrinsic risk factors should be encouraged to prevent falls practically and they need practical preventive methods. All doctors that care of the elderly should recommend preventive protocols to them.